Impact of cancer treatment on fertility in women

Joe Letourneau, MD, and Deepika Garg, MD. Credit: Huntsman Cancer Institute

In the United States, approximately 125,000 women of childbearing age (15-45 years) were diagnosed with cancer in 2018, according to the National Cancer Institute Survival, Epidemiology, and End Results database. Thanks to improvements in cancer research that have led to more effective treatments and better prevention and early detection methods, more than 80% of those women will become long-term survivors of their cancer diagnosis.

Yet many cancer survivors face a difficult reality, as cancer itself, or the treatments to beat the disease, can also have a major impact on a person’s ability to have children. That is why a lot has been invested in the medical field in a practice called oncofertility. This field of medicine aims to bridge the gap between oncology and reproductive medicine and help cancer patients and survivors who wish to have children.

New research published in October 2021 in F&S Reports shows how cancer affects fertility. Researchers outline findings on birth rate in the healthy population compared to cancer survivors.

The studies were led by Joe Letourneau, MD, a physician of reproductive medicine and assistant professor of obstetrics and gynecology at the University of Utah Health. Letourneau also provides oncofertility care to patients at the Huntsman Cancer Institute. “Many cancer treatments are now recognized to have a negative impact on fertility,” Letourneau says. “Post-cancer fertility is an important quality of life issue, and patients have a strong desire to understand the effects of cancer treatments on their fertility and their ability to have healthy children in the future.”

Deepika Garg, MD, who completed her fellowship in reproductive endocrinology and infertility at U of U Health, advanced the oncofertility projects during her fellowship. “We found the association between cancer and its treatment and a subsequent reduced risk of live births in women of reproductive age,” Garg says. The researchers found that the reduction in live births was most prominent in women diagnosed at age 40 or older.

Garg completed this project as part of her fellowship training. “I became interested in this issue because many of my patients were looking for advice about how cancer will affect their chances of having a child,” she says.

This study complements further work by Garg and Letourneau that outlines some of the specific changes that occur in individual patients following cancer treatment. Garg recently presented at the annual meeting of the American Society for Reproductive Medicine, sharing the results of their analysis of tissue samples from Hodgkin lymphoma survivors. They found that approximately 2.5 years after chemotherapy, a time when many Hodgkin lymphoma survivors can resume their family formation, endometrial thickness and endometrial histology were not significantly affected by a history of chemotherapy exposure.

“With continued and substantial advances in cancer treatment, there has been a rapid increase in the population of long-term cancer survivors among adolescents and young adults,” Garg says. “Therefore, there has been increasing emphasis on the long-term effects of cancer therapies and on quality of life. The potential impact on fertility is one of the concerns of paramount importance to my patients after their cancer treatment.”

Garg and Letourneau hope these results will expand the evaluation of the specific problems that cause adverse effects of cancer treatment on fertility. They also aim to educate the community about the role of oncofertility in cancer patients during the adolescence or reproductive years. Their goal is to use these insights to further refine clinical guidelines for preserving fertility during the cancer treatment process.

Many young cancer patients receive insufficient information and support about fertility

More information:
Deepika Garg et al, Cancer treatment is associated with a measurable reduction in live births in a large, population-based study, F&S Reports (2021). DOI: 10.1016/j.xfre.2021.08.004

Provided by Huntsman Cancer Institute

Quote: Impact of Cancer Treatment on Female Fertility (2021, Dec 16) Retrieved Dec 16, 2021 from

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