Researchers have found that although women who survived cancer in their childhood have an increased risk of infertility, they still have a good chance of conceiving.
The study, published in The Lancet Oncology, revealed that around two-thirds of women who suffered from childhood cancer become pregnant. The researchers say this is a pregnancy rate similar to that seen in non-cancer survivors who have received infertility treatment.
Researchers from Dana-Farber/Boston Children's Cancer and Blood Disorders Center, as well as Brigham and Women's Hospital in Boston, carried out a survey of participants in the Childhood Cancer Survivor Study (CCCS). The study tracks people who were diagnosed with cancer under the age of 21 at over 26 US and Canadian institutions.
The study focused on women who were trying to get pregnant. The researchers analyzed 3,531 women from the CCCS aged between 18 and 39 years who reported being sexually active at some point in their lives, as well as 1,366 of the women's female siblings for comparison.
Researchers suggest that although women who survived childhood cancer are at increased risk of infertility, their odds of conceiving are still good.
The results showed that of 455 study participants who reported clinical infertility, 64% of them eventually became pregnant.
The results also revealed that in the youngest group of survivors and their siblings, who were under the age of 24, infertility was almost three times more common in the survivors than in their siblings.
But the results showed that this difference was less pronounced in women in their late 30s. The study authors say this may be because infertility is more common in all women in that age group and is not limited to cancer survivors.
Surprisingly, the study also revealed that although survivors were just as likely as their siblings to seek medical treatment for infertility, the siblings were twice as likely to be prescribed drugs for it.
Dr Sara Barton, the leader of this study, says:
"We do not have data about why providers did not prescribe infertility drugs, but are concerned about a provider bias against treating cancer survivors for infertility.
Perhaps providers assessed the chance of success as poor and therefore decided not to attempt therapy, or perhaps survivors were less motivated to take drugs after previous extensive treatment. Alternatively, reproductive medicine providers might have been uncomfortable with perceived medical comorbidities."
Barton adds that clinicians caring for childhood cancer survivors who request information about the likelihood of pregnancy or the success of infertility treatment have a scarce amount of data on which to provide recommendations.
She adds: "To our knowledge, ours is the first large study of female childhood cancer survivors to quantify the risk of infertility that is based on a clinical definition, and characterizes the use and success of infertility treatments in this setting."
In a comment alongside the study, Richard Anderson of the MRC Centre for Reproductive Health at the UK's University of Edinburgh says: "Barton and colleagues' data highlight the risk of infertility in childhood cancer survivors beyond the risk of ovarian failure and the need for this risk to be addressed by oncologists at the time of diagnosis and during follow-up as a key part of long-term care."