Greta Sommerhäuser1, Anja Borgmann-Staudt2, Kathy Astrahantseff1, Katja Baust3, Gabriele Calaminus3, Ralf Dittrich4, Marta J Fernández-González1, Heike Hölling5, Charlotte J König1, Ralph Schilling1,6, Theresa Schuster1, Laura Lotz4, Magdalena Balcerek1,7. 1. Department of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany. 2. Department of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany. anja.borgmann@charite.de. 3. University Hospital Bonn (UKB), Venusberg-Campus 1, 53127, Bonn, Germany. 4. Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University of Erlangen-Nürnberg, Maximiliansplatz 2, 91054, Erlangen, Germany. 5. Robert Koch-Institute Berlin, General-Papestr. 62-66, 12101, Berlin, Germany. 6. Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Biometry and Clinical Epidemiology (IBiKE), Charitéplatz 1, 10117, Berlin, Germany. 7. Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Straße 2, 10178, Berlin, Germany.
Abstract
PURPOSE: An increasing number of childhood cancer survivors are using assisted reproductive technologies (ART) to overcome treatment-related fertility impairment. We report perinatal and health outcomes of offspring born to survivors following ART. METHODS: The FeCt Multicenter Offspring Study surveyed the health of offspring of childhood cancer survivors. Health outcomes in offspring born to survivors following ART (n = 57, 4.6%) or after spontaneous conception (n = 1182) were assessed in the German cohort (n = 1239) using bivariate analysis. Findings were put into the context of the general German population by health outcome assessment in 1:1 matched-pair analysis (n = 2478). RESULTS: Nearly twice the survivors used ART compared with numbers reported for the German general population (4.6% vs. 2.6%). Successful pregnancies were achieved after a median of two cycles, mainly using non-cryopreserved oocytes/sperm. Multiple sibling births (p < 0.001, 28.1% vs. 3.0%) and low birth weight (p = 0.008; OR = 2.659, 95% CI = 1.258-5.621) occurred significantly more often in offspring born to survivors who utilized ART than spontaneously conceived children, whereas similar percentages were born preterm or too small for their gestational age. ART did not increase the prevalence of childhood cancer or congenital malformations in offspring born to survivors. CONCLUSION: ART use by childhood cancer survivors was successful with both fresh and cryopreserved oocytes/sperm, and did not influence perinatal health or health outcomes when known confounders were taken into account. IMPLICATIONS FOR CANCER SURVIVORS: Oncofertility is an important component of patient care. Our study implicates that the utilization of ART by adult survivors of childhood cancer does not put offspring at additional risk for adverse perinatal or health outcomes.
PURPOSE: An increasing number of childhood cancer survivors are using assisted reproductive technologies (ART) to overcome treatment-related fertility impairment. We report perinatal and health outcomes of offspring born to survivors following ART. METHODS: The FeCt Multicenter Offspring Study surveyed the health of offspring of childhood cancer survivors. Health outcomes in offspring born to survivors following ART (n = 57, 4.6%) or after spontaneous conception (n = 1182) were assessed in the German cohort (n = 1239) using bivariate analysis. Findings were put into the context of the general German population by health outcome assessment in 1:1 matched-pair analysis (n = 2478). RESULTS: Nearly twice the survivors used ART compared with numbers reported for the German general population (4.6% vs. 2.6%). Successful pregnancies were achieved after a median of two cycles, mainly using non-cryopreserved oocytes/sperm. Multiple sibling births (p < 0.001, 28.1% vs. 3.0%) and low birth weight (p = 0.008; OR = 2.659, 95% CI = 1.258-5.621) occurred significantly more often in offspring born to survivors who utilized ART than spontaneously conceived children, whereas similar percentages were born preterm or too small for their gestational age. ART did not increase the prevalence of childhood cancer or congenital malformations in offspring born to survivors. CONCLUSION: ART use by childhood cancer survivors was successful with both fresh and cryopreserved oocytes/sperm, and did not influence perinatal health or health outcomes when known confounders were taken into account. IMPLICATIONS FOR CANCER SURVIVORS: Oncofertility is an important component of patient care. Our study implicates that the utilization of ART by adult survivors of childhood cancer does not put offspring at additional risk for adverse perinatal or health outcomes.
Entities:
Keywords:
Assisted reproductive technologies; Childhood cancer survivor; Infertility; Offspring; Pediatric cancer
Authors: Lisa B Signorello; John J Mulvihill; Daniel M Green; Heather M Munro; Marilyn Stovall; Rita E Weathers; Ann C Mertens; John A Whitton; Leslie L Robison; John D Boice Journal: J Clin Oncol Date: 2011-12-12 Impact factor: 44.544
Authors: Béatrice Blondel; Michael D Kogan; Greg R Alexander; Nirupa Dattani; Michael S Kramer; Alison Macfarlane; Shi Wu Wen Journal: Am J Public Health Date: 2002-08 Impact factor: 9.308
Authors: Rebecca F Liberman; Kelly D Getz; Dominique Heinke; Barbara Luke; Judy E Stern; Eugene R Declercq; Xiaoli Chen; Angela E Lin; Marlene Anderka Journal: Birth Defects Res Date: 2017-06-21 Impact factor: 2.344
Authors: Roderick Skinner; Renee L Mulder; Leontien C Kremer; Melissa M Hudson; Louis S Constine; Edit Bardi; Annelies Boekhout; Anja Borgmann-Staudt; Morven C Brown; Richard Cohn; Uta Dirksen; Alexsander Giwercman; Hiroyuki Ishiguro; Kirsi Jahnukainen; Lisa B Kenney; Jacqueline J Loonen; Lilian Meacham; Sebastian Neggers; Stephen Nussey; Cecilia Petersen; Margarett Shnorhavorian; Marry M van den Heuvel-Eibrink; Hanneke M van Santen; William H B Wallace; Daniel M Green Journal: Lancet Oncol Date: 2017-02 Impact factor: 41.316
Authors: Mariana Sbrana; Carlos Grandi; Murilo Brazan; Natacha Junquera; Marina Stevaux Nascimento; Marco Antonio Barbieri; Heloisa Bettiol; Viviane Cunha Cardoso Journal: Sao Paulo Med J Date: 2016-03-18 Impact factor: 1.044
Authors: M S Kupka; A P Ferraretti; J de Mouzon; K Erb; T D'Hooghe; J A Castilla; C Calhaz-Jorge; C De Geyter; V Goossens Journal: Hum Reprod Date: 2014-07-27 Impact factor: 6.918