Barbara Luke1, Morton B Brown2, Logan G Spector3, Judy E Stern4, Yolanda R Smith5, Melanie Williams6, Lori Koch7, Maria J Schymura8. 1. Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, 965 Fee Road, East Fee Hall, Room 628, East Lansing, Michigan, 48824, USA. lukeb@msu.edu. 2. Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA. 3. Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA. 4. Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA. 5. Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA. 6. Texas Cancer Registry, Cancer Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, USA. 7. Illinois State Cancer Registry, Illinois Department of Public Health, Springfield, Illinois, USA. 8. New York State Cancer Registry, Bureau of Cancer Epidemiology, New York State Department of Health, Albany, New York, USA.
Abstract
PURPOSE: The purpose of the present study is to estimate the proportion of women with cancer who return to use the embryos that they have banked and to compare this proportion to that of women without cancer who bank embryos. METHODS: This is a cohort study of three groups of women from New York, Texas, and Illinois who used embryo banking in their first assisted reproductive technology (ART) treatment cycle: two groups with cancer (222 women without an infertility diagnosis and 48 women with an infertility diagnosis) and a control group without cancer (68 women with the infertility diagnosis of male factor only). Women were included only if their first ART cycle reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) occurred between 2004 and 2009. Cancer cases were identified from each State Cancer Registry from 5 years prior to initiation of ART treatment to 6 months post-initiation; mean follow-up after the first ART cycle was 2.0 years. RESULTS: Women with cancer without an infertility diagnosis returned for a subsequent ART cycle at a lower rate (10.8 %) than those with an infertility diagnosis (31.3 %, p = 0.0010) or the control group (85.3 %, p < 0.0001). Among those who returned for a subsequent cycle, women with cancer waited a longer time to return (14.3 months without an infertility diagnosis and 8.3 months with an infertility diagnosis, p = 0.13) compared to the control group (2.8 months, p = 0.0007). The live birth rate among women who did not utilize embryo banking in their second cycle did not differ significantly across the three study groups, ranging from 25.0 and 42.9 % for women with cancer with and without an infertility diagnosis, respectively, to 36.2 % for women in the control group. CONCLUSIONS: Women with cancer without an infertility diagnosis are either less likely to return for subsequent treatment or will wait a longer time to return than women with an infertility diagnosis or those that do not have cancer. A longer-term study is necessary to assess whether these women return to use their frozen embryos after cancer treatment or are able to spontaneously conceive and if those subsequent pregnancies are adversely affected by the cancer diagnosis or therapy.
PURPOSE: The purpose of the present study is to estimate the proportion of women with cancer who return to use the embryos that they have banked and to compare this proportion to that of women without cancer who bank embryos. METHODS: This is a cohort study of three groups of women from New York, Texas, and Illinois who used embryo banking in their first assisted reproductive technology (ART) treatment cycle: two groups with cancer (222 women without an infertility diagnosis and 48 women with an infertility diagnosis) and a control group without cancer (68 women with the infertility diagnosis of male factor only). Women were included only if their first ART cycle reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) occurred between 2004 and 2009. Cancer cases were identified from each State Cancer Registry from 5 years prior to initiation of ART treatment to 6 months post-initiation; mean follow-up after the first ART cycle was 2.0 years. RESULTS:Women with cancer without an infertility diagnosis returned for a subsequent ART cycle at a lower rate (10.8 %) than those with an infertility diagnosis (31.3 %, p = 0.0010) or the control group (85.3 %, p < 0.0001). Among those who returned for a subsequent cycle, women with cancer waited a longer time to return (14.3 months without an infertility diagnosis and 8.3 months with an infertility diagnosis, p = 0.13) compared to the control group (2.8 months, p = 0.0007). The live birth rate among women who did not utilize embryo banking in their second cycle did not differ significantly across the three study groups, ranging from 25.0 and 42.9 % for women with cancer with and without an infertility diagnosis, respectively, to 36.2 % for women in the control group. CONCLUSIONS:Women with cancer without an infertility diagnosis are either less likely to return for subsequent treatment or will wait a longer time to return than women with an infertility diagnosis or those that do not have cancer. A longer-term study is necessary to assess whether these women return to use their frozen embryos after cancer treatment or are able to spontaneously conceive and if those subsequent pregnancies are adversely affected by the cancer diagnosis or therapy.
Entities:
Keywords:
Assisted reproduction; Cancer among women; Cohort study; Oncofertility
Authors: Judy E Stern; Morton B Brown; Barbara Luke; Ethan Wantman; Avi Lederman; Mark D Hornstein Journal: Fertil Steril Date: 2010-07-18 Impact factor: 7.329
Authors: S N Nielsen; A N Andersen; K T Schmidt; C Rechnitzer; K Schmiegelow; J G Bentzen; E C Larsen Journal: Reprod Biomed Online Date: 2013-04-18 Impact factor: 3.828
Authors: Barbara Luke; Morton B Brown; Ethan Wantman; Avi Lederman; William Gibbons; Glenn L Schattman; Rogerio A Lobo; Richard E Leach; Judy E Stern Journal: N Engl J Med Date: 2012-06-28 Impact factor: 91.245
Authors: Judy E Stern; Morton B Brown; Barbara Luke; Ethan Wantman; Avi Lederman; Stacey A Missmer; Mark D Hornstein Journal: Fertil Steril Date: 2009-07-10 Impact factor: 7.329