title: Fertility following treatment of high-grade malignant bone and soft tissue tumors in young adults.
abstract: This study was conducted to investigate marriage and fertility in long-term survivors with high-grade bone and soft tissue tumors following chemotherapy. We reviewed issues related to fertility in 47 patients (24 men and 23 women) who had survived for >5 years. The median age at diagnosis was 18.0±8.9 years and the mean duration of follow-up 11.0 years. We investigated the proportions of married subjects (number of married/total number of subjects) and fertile subjects (number who had fathered or conceived offspring/total number of subjects), the interval between first delivery and last chemotherapy, type of delivery, congenital deformities in the offspring and the association between cumulative dose of chemotherapeutic agents and subsequent reproduction. The final proportions of married and fertile subjects following sarcoma treatment were 36.2% (17/47) and 29.8% (14/47), respectively. Two subjects had fathered and 8 had conceived a total of 15 offspring. The proportion of fertile men was significantly lower compared to that of women. The mean interval between the last chemotherapy and the first delivery was 9.5 years. Of the 10 first births, 6 were normal transvaginal deliveries and 4 were caesarean sections (1 was a medical termination due to lung metastases, 1 was due to infected amniotic fluid caused by uterine myomas and 2 were performed due to abnormal rotation of the fetus). No offspring presented with congenital deformities. Fertile men had received smaller cumulative chemotherapeutic agent doses, particularly of ifosfamide, compared to those who had not fathered any offspring. In conclusion, infertility occurs more frequently in men compared to women following intensive chemotherapy. All the patients should be offered counseling regarding the potential risk of infertility prior to cancer treatment.
authors: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.
authors: Manabu
authors: M
authors: Hoshi
authors: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.
authors: Masatsugu
authors: M
authors: Takami
authors: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.
authors: Makoto
authors: M
authors: Ieguchi
authors: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.
authors: Masanari
authors: M
authors: Aono
authors: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.
authors: Jun
authors: J
authors: Takada
authors: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.
authors: Naoto
authors: N
authors: Oebisu
authors: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.
authors: Tadashi
authors: T
authors: Iwai
authors: Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.
authors: Hiroaki
authors: H
authors: Nakamura
keywords: chemotherapy; childbirth; fertility; marriage; sarcoma