Despite treatment for childhood
cancer causing an increased risk of infertility, most women still
manage to conceive, research
has shown. Although it took longer on average, 64 percent of former cancer patients managed to become pregnant.
Patients surviving childhood cancer were
48 percent more likely to be affected by 'clinical infertility', defined as
unsuccessfully attempting to conceive for a year or longer. This risk was
particularly increased in younger women.
Researchers from Brigham and Women's Hospital and
Children's Cancer and Blood Disorders Center, USA, used a large childhood cancer study to compare
pregnancy rates between 3,500 women affected by childhood cancer to 1,300 of
'Most women think that if they
had cancer as a child, then they'll never have children. It turns out that many
of them can get pregnant. It just might be a little harder', said lead author Dr Lisa Diller. 'Women who have
a history of childhood cancer treatment should consider themselves likely to be
fertile. However, it might be important to see an expert sooner rather than
later if a desired pregnancy doesn't happen within the first six months'.
Cancer treatment has become more
effective and IVF uptake has increased since the study began in 1992, meaning
the risk of infertility is lower for today's young cancer patients. However,
alkylating agents and pelvic radiotherapy are still in clinical use, so this report's findings are
The importance of such research
is highlighted by another recent
publication which showed that many women who had childhood cancer
were dissatisfied with how the impact of their treatment on their fertility was
discussed with them.
Patients of both sexes were surveyed
in 2004 and again in 2011. Women were dissatisfied with the quality
of fertility discussions on both occasions, with fewer women than men remembering such a talk occurring before their cancer treatment began. In 2011
more women remembered a talk before treatment than in 2004, yet they were no
While only based on patient
recollections, this study backs up previous anecdotal data. 'This study
highlights the need to discuss fertility issues with young patients, especially
females, before treatment begins even if there are no options available for
fertility preservation', Dr Dan Yeomanson, Consultant Paediatric Oncologist
from the Children's NHS Foundation Trust in Sheffield told the BBC.
The authors speculate that
higher satisfaction among men might be partly because sperm freezing offers a
relatively convenient method to preserve fertility post-treatment, compared to
egg embryo or ovary cryopreservation.
These studies underline some of
the issues surrounding the reproductive health of young cancer patients; while
many women report dissatisfaction with the discussion of possible
infertility, it seems that most still manage to achieve pregnancy.