Fertility After Cancer Treatment

Main Category: Fertility
Also Included In: Cancer / Oncology
Article Date: 08 Feb 2008 - 1:00 PDT

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Improved cancer survival in adolescence and young adulthood means that many who have previously had cancer become parents, especially men. The Norwegian Radium Hospital and the Norwegian Institute of Public Health (NIPH) have studied how many go on to become parents and whether their children are healthy.

Parenthood patterns for former cancer patients were identified through the Medical Birth Register at the NIPH. All had been diagnosed with cancer between 15 and 35 years old.

Becoming a father

The probability of becoming a father at 35 years old was 63 percent amongst men who had had cancer. This was similar to the general population's probability of 64 per cent. In other words, a former cancer patient had as good a chance as other men to become a father in his 30s.

Amongst women, the probability of having children at 35 years old was reduced. At this age, a former cancer patient had 66 percent chance of becoming a mother compared to 79 percent in the general population.

A gentle, fertility-protecting treatment regime for young cancer patients has been adopted since 1985-90. In addition, men have the option to freeze their sperm for later use. Researchers noticed that a high number of men with testicular cancer and lymph cancer become fathers, most doing so by natural means. It would seem that treatment affects fertility to a larger degree for women than for men. This can be explained by the type of chemotherapy used, radiation and surgery, plus the type of diagnosis and whether the woman can physically bear a child.

The study covered approximately 750 former cancer patients and was a collaboration between the Norwegian Radium Hospital and the Medical Birth Register. Births up to the first half of 2004 are included. The results are published in the journal Human Reproduction.

High risk pregnancy for women

Women who had children after cancer treatment had a slightly increased risk of giving birth to a child with low birth weight; the risk was 10 percent versus 5 percent in the general population. These women also had an increased risk of premature birth; 15 percent against 7 percent in the general population. This could be caused by anatomical changes after gynaecological operations and radiotherapy.

There was also an increased risk that the child would be stillborn or die after birth although the difference is 2.8 percent compared to a risk of 1.4 percent in the general population.

The researchers comment that women who go on to have children after cancer treatment should be closely observed and be considered as high-risk pregnancies.

Increased risk

Researchers also investigated if there was a higher mortality rate and an increased number of babies born with congenital abnormalities to former cancer patients.

The results show that men who have children after cancer have a somewhat increased risk of having a child with a congenital abnormality. This was unexpected. Amongst children of former male cancer patients, 5.5 percent (1 in 20) had a major or minor abnormality compared to 3.2 percent (1 in 30) in the general population. The most common abnormalities included different musculoskeletal abnormalities, including congenital dysplasia of the hip. The abnormalities had no link with artificial fertilisation.

There was no increased risk of abnormalities amongst women who had had cancer and went on to have children later.

The figures for both groups are small and should therefore be investigated further in new studies.

Cancer in the age group 15-35 years

Statistics from the Norwegian Cancer Register show that 286 men and 344 women in the age group 15-35 years developed cancer in 2006. In the study referred to in this article, most of the men had testicular cancer or lymph cancer. The women were diagnosed with different types of cancer, most commonly gynaecological cancers, lymph cancers and breast cancer.

Norwegian Institute of Public Health