BACKGROUND: Future fertility is an important concern for many cancer survivors. Cancer therapies have been shown to adversely impact reproductive function. However, it is difficult to predict the extent to which reproductive dysfunction will occur. The purpose of this study was to compare measures of ovarian reserve (MOR) and pregnancy rates in young female cancer survivors and similar-aged controls. PROCEDURES: A prospective cohort study was conducted in a university-hospital setting. Participants were followed annually for a mean 25 months to assess reproductive history, the incidence of pregnancy, and MOR (serum follicle-stimulating hormone, luteinizing hormone, estradiol, inhibin B, anti-mullerian hormone (AMH), antral follicle counts and mean ovarian volume). RESULTS: Eighty-four female survivors (average age 26, and 14 years post-treatment) and 98 similar-aged controls that were sexually active with men were included. At baseline, 27/84 survivors and 42/98 controls reported a prior pregnancy. Adjusted models showed that anti-mullerian hormone (AMH) and antral follicle count (AFC) were impaired in survivors with a prior pregnancy compared to controls with a prior pregnancy (P < 0.01, P = 0.03). During follow-up in 56 survivors and 74 controls, 19 pregnancies occurred in survivors and 18 in controls. Comparison of MOR between survivors who became pregnant and controls who became pregnant revealed that AMH and AFC were impaired in survivors (P < 0.05). Compared to survivors who did not become pregnant, survivors who did were older (P < 0.01) and more likely to be cohabitating (P < 0.01), but had similar MOR and exposure to alkylators (P = 0.34). CONCLUSIONS: Survivors achieved pregnancy at a rate similar to controls despite impaired MOR.
BACKGROUND: Future fertility is an important concern for many cancer survivors. Cancer therapies have been shown to adversely impact reproductive function. However, it is difficult to predict the extent to which reproductive dysfunction will occur. The purpose of this study was to compare measures of ovarian reserve (MOR) and pregnancy rates in young female cancer survivors and similar-aged controls. PROCEDURES: A prospective cohort study was conducted in a university-hospital setting. Participants were followed annually for a mean 25 months to assess reproductive history, the incidence of pregnancy, and MOR (serum follicle-stimulating hormone, luteinizing hormone, estradiol, inhibin B, anti-mullerian hormone (AMH), antral follicle counts and mean ovarian volume). RESULTS: Eighty-four female survivors (average age 26, and 14 years post-treatment) and 98 similar-aged controls that were sexually active with men were included. At baseline, 27/84 survivors and 42/98 controls reported a prior pregnancy. Adjusted models showed that anti-mullerian hormone (AMH) and antral follicle count (AFC) were impaired in survivors with a prior pregnancy compared to controls with a prior pregnancy (P < 0.01, P = 0.03). During follow-up in 56 survivors and 74 controls, 19 pregnancies occurred in survivors and 18 in controls. Comparison of MOR between survivors who became pregnant and controls who became pregnant revealed that AMH and AFC were impaired in survivors (P < 0.05). Compared to survivors who did not become pregnant, survivors who did were older (P < 0.01) and more likely to be cohabitating (P < 0.01), but had similar MOR and exposure to alkylators (P = 0.34). CONCLUSIONS: Survivors achieved pregnancy at a rate similar to controls despite impaired MOR.
Authors: S Lie Fong; J S E Laven; F G A J Hakvoort-Cammel; I Schipper; J A Visser; A P N Themmen; F H de Jong; M M van den Heuvel-Eibrink Journal: Hum Reprod Date: 2009-01-18 Impact factor: 6.918
Authors: Robert D van Beek; Marry M van den Heuvel-Eibrink; Joop S E Laven; Frank H de Jong; Axel P N Themmen; Friederike G Hakvoort-Cammel; Cor van den Bos; Henk van den Berg; Rob Pieters; Sabine M P F de Muinck Keizer-Schrama Journal: J Clin Endocrinol Metab Date: 2007-08-28 Impact factor: 5.958
Authors: MaryFran R Sowers; Aimee D Eyvazzadeh; Daniel McConnell; Matheos Yosef; Mary L Jannausch; Daowen Zhang; Sioban Harlow; John F Randolph Journal: J Clin Endocrinol Metab Date: 2008-07-01 Impact factor: 5.958
Authors: Daniel M Green; Toana Kawashima; Marilyn Stovall; Wendy Leisenring; Charles A Sklar; Ann C Mertens; Sarah S Donaldson; Julianne Byrne; Leslie L Robison Journal: J Clin Oncol Date: 2009-04-13 Impact factor: 44.544
Authors: Thomas W Kelsey; Phoebe Wright; Scott M Nelson; Richard A Anderson; W Hamish B Wallace Journal: PLoS One Date: 2011-07-15 Impact factor: 3.240
Authors: Sally A Dominick; Brian W Whitcomb; Jessica R Gorman; Jennifer E Mersereau; Karine Chung; H Irene Su Journal: J Cancer Surviv Date: 2014-05-24 Impact factor: 4.442
Authors: Sana M Salih; Sarah Z Elsarrag; Elizabeth Prange; Karli Contreras; Radya G Osman; Jens C Eikoff; Diane Puccetti Journal: J Pediatr Adolesc Gynecol Date: 2014-06-07 Impact factor: 1.814
Authors: Lauren N C Johnson; Mary D Sammel; Katherine E Dillon; Lara Lechtenberg; Allison Schanne; Clarisa R Gracia Journal: Fertil Steril Date: 2014-06-14 Impact factor: 7.329
Authors: Jennifer M Levine; John A Whitton; Jill P Ginsberg; Daniel M Green; Wendy M Leisenring; Marilyn Stovall; Leslie L Robison; Gregory T Armstrong; Charles A Sklar Journal: Cancer Date: 2018-01-16 Impact factor: 6.860
Authors: Barbara Luke; Morton B Brown; Logan G Spector; Judy E Stern; Yolanda R Smith; Melanie Williams; Lori Koch; Maria J Schymura Journal: J Assist Reprod Genet Date: 2016-02-03 Impact factor: 3.412
Authors: Alison Leiper; Maite Houwing; E Graham Davies; Kanchan Rao; Siobhan Burns; Emma Morris; Joop Laven; Anne-Lotte van der Kooi; Marry van den Heuvel Eibrink; Stephen Nussey Journal: Bone Marrow Transplant Date: 2020-03-30 Impact factor: 5.483