title: A 10-year follow up of reproductive function in women treated for childhood cancer.
abstract: Previously, this study group found that female childhood cancer survivors could be at risk of early cessation of fertility. The aim of the present study was to evaluate reproductive function in the same group of survivors 10 years after the initial study. Of the original cohort of 100, 71 were re-examined. Thirty-six survivors reported regular menstrual cycles. When they were compared with 210 controls, they differed significantly in antral follicle count (AFC) (median 15 versus 18, P=0.047) but not in anti-Müllerian hormone (AMH) (median 13.0 versus 17.8 pmol/l). Survivors cured with minimal gonadotoxic treatment had significantly higher AMH and AFC compared with survivors cured with either potentially gonadotoxic treatment or treatment including alkylating chemotherapy and ovarian irradiation (20.0, 5.8 and <3 pmol/l, P<0.001; and 15, 9 and 2, P=0.03, respectively). Thirty-eight survivors had achieved at least one live birth. Complicated second-trimester abortions (n=4) were observed primarily in survivors cured with radiotherapy affecting pelvic organs. In conclusion, childhood cancer survivors have signs of diminished ovarian reserve. However, if the ovarian function is preserved in the early to mid-twenties, it is likely to persist until the mid-thirties, giving a good chance of childbearing.
authors.affiliation: The Fertility Clinic, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
authors.forename: S N
authors.initials: SN
authors.lastname: Nielsen
authors.forename: A N
authors.initials: AN
authors.lastname: Andersen
authors.forename: K T
authors.initials: KT
authors.lastname: Schmidt
authors.forename: C
authors.initials: C
authors.lastname: Rechnitzer
authors.forename: K
authors.initials: K
authors.lastname: Schmiegelow
authors.forename: J G
authors.initials: JG
authors.lastname: Bentzen
authors.forename: E C
authors.initials: EC
authors.lastname: Larsen
mesh_terms: D000022:Abortion, Spontaneous / Q000097:blood / Q000139:chemically induced / Q000209:etiology / Q000473:pathology; D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D015331:Cohort Studies; D003718:Denmark; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000139:chemically induced / Q000150:complications* / Q000209:etiology / Q000473:pathology; D050498:Live Birth; D008599:Menstruation Disturbances / Q000139:chemically induced / Q000150:complications* / Q000209:etiology / Q000473:pathology; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D010053:Ovary / Q000187:drug effects / Q000473:pathology* / Q000528:radiation effects; D011247:Pregnancy; D016649:Primary Ovarian Insufficiency / Q000139:chemically induced / Q000150:complications* / Q000209:etiology / Q000473:pathology; D012074:Remission Induction; D012306:Risk; D017741:Survivors; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D054304:Anti-Mullerian Hormone
keywords: chemotherapy; childhood malignancy; radiotherapy; reproductive function