title: Fertility among female hodgkin lymphoma survivors attempting pregnancy following ABVD chemotherapy.
abstract: Although ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) chemotherapy is infrequently associated with premature amenorrhea, little is known about the success rate of women attempting pregnancy following ABVD. In the present study females treated for HL with ABVD chemotherapy without pelvic radiation therapy (RT) and who were alive without relapse > or =3 years after treatment were identified from a clinical database and screened for inclusion. Using a standardized questionnaire, we determined the pregnancy rate (i.e. time-to-pregnancy, TTP) among survivors who had become pregnant, tried to become pregnant, or who had been sexually active for over 2 months without using contraception at any time following ABVD. The cumulative incidence of pregnancy was calculated using the Kaplan-Meier method. Cox proportional hazards models were constructed to compare the pregnancy rate among HL survivors to that reported by friend or sibling controls. Thirty-six female HL survivors, who had attempted pregnancy after ABVD treatment, and 29 controls, completed the survey. Eighteen patients (50%) received 2-4 cycles of ABVD, 16 (44%) received 4-6 cycles, and 2 (6%) received >6 cycles. The median TTP among both HL survivors and controls was 2.0 months. The 12-month pregnancy rates were 70% and 75%, respectively. The fertility ratio (FR) for HL survivors versus controls was 0.94 (95%CI = 0.53-1.66; p = 0.84) after adjusting for age and frequency of intercourse (where FR < 1 indicates subfertility). Age at treatment and the number of cycles of chemotherapy were not associated with pregnancy rate among HL survivors. Female HL patients who had survived without recurrence > or =3 years and who had attempted pregnancy after ABVD did not experience significant sub-fertility.
authors.affiliation: Department of Radiation Oncology, Princess Margaret Hospital, University Health Network, Toronto, Canada. david.hodgson@rmp.uhn.on.ca
authors.forename: David C
authors.initials: DC
authors.lastname: Hodgson
authors.forename: Melania
authors.initials: M
authors.lastname: Pintilie
authors.forename: Leah
authors.initials: L
authors.lastname: Gitterman
authors.forename: Beth
authors.initials: B
authors.lastname: Dewitt
authors.forename: Carol-Ann
authors.initials: CA
authors.lastname: Buckley
authors.forename: Sameera
authors.initials: S
authors.lastname: Ahmed
authors.forename: Katherine
authors.initials: K
authors.lastname: Smith
authors.forename: Amanda
authors.initials: A
authors.lastname: Schwartz
authors.forename: Richard W
authors.initials: RW
authors.lastname: Tsang
authors.forename: Michael
authors.initials: M
authors.lastname: Crump
authors.forename: Woodrow
authors.initials: W
authors.lastname: Wells
authors.forename: Alexander
authors.initials: A
authors.lastname: Sun
authors.forename: Mary K
authors.initials: MK
authors.lastname: Gospodarowicz
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology* / Q000627:therapeutic use; D001761:Bleomycin / Q000627:therapeutic use; D016022:Case-Control Studies; D003606:Dacarbazine / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D005298:Fertility / Q000187:drug effects*; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D011795:Surveys and Questionnaires; D017741:Survivors; D014747:Vinblastine / Q000627:therapeutic use
chemical_list: D001761:Bleomycin; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin