Tags

Type your tag names separated by a space and hit enter

Survey of Reproductive Experiences and Outcomes of Cancer Survivors Who Stored Reproductive Material Before Treatment.
Hum Reprod. 2017 Dec 01; 32(12):2423-2430.HR

Abstract

STUDY QUESTION

What are the reproductive experiences and outcomes of people who store reproductive material before cancer treatment?

SUMMARY ANSWER

Of respondents who had tried to achieve pregnancy since completing cancer treatment almost all had succeeded, in most cases through natural conception.

WHAT IS KNOWN ALREADY

People of reproductive age who are diagnosed with cancer can cryopreserve reproductive material to guard against the adverse effects on fertility of gonadotoxic treatment. Little is known about the reproductive outcomes of people who undergo fertility preservation before cancer treatment.

STUDY DESIGN, SIZE, DURATION

Cross-sectional survey.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Women and men who had stored reproductive material before cancer treatment at two private and one public fertility clinics up to June 2014 and were at least 18 years old at the time were identified from medical records and invited to complete an anonymous questionnaire about their reproductive experiences.

MAIN RESULTS AND THE ROLE OF CHANCE

Of the 870 potential respondents 302 (171 female and 131 male) returned completed questionnaires yielding a response rate of 34.5% (39.5% and 29.7% for female and male respondents, respectively). Current age was similar for women and men (37.2 years) but men had been diagnosed with cancer significantly earlier in life than women (28.2 versus 30.3 years, P = 0.03). Almost two-thirds of respondents wished to have a child or another child in the future, some of whom knew that they were unable to. One in ten respondents was a parent before the cancer diagnosis and around one-third had had a child since diagnosis or was pregnant (or a partner in pregnancy) at the time of the survey. Of those who had tried to conceive since completing cancer treatment (N = 119) 84% (79% of women and 90% of men) had had a child or were pregnant (or a partner in pregnancy). Most of the pregnancies since the diagnosis of cancer occurred after natural conception (58/100, 58%). Of the 22 women (13% of all women) and 35 men (27% of all men) who had used their stored reproductive material four women (18%) and 28 men (80%) had had a child or were pregnant or a partner in pregnancy at the time of completing the survey. The most commonly stated reason for not using the stored material was not being ready to try for a baby.

LIMITATIONS, REASON FOR CAUTION

The relatively low response rate, particularly among men, means that participation bias may have influenced the findings. As type of cancer was self-reported and we did not ask questions about respondents' cancer treatments, it is not possible to link reproductive outcomes to type of cancer or cancer treatment. Also, there is no way of comparing the sample with the populations they were drawn from as data on reproductive outcomes of people who store reproductive material before cancer treatment are not collected routinely. This might have led to over- or underestimates of the reproductive experiences and outcomes reported in this paper.

WIDER IMPLICATIONS OF THE FINDINGS

The findings add to the limited evidence about the reproductive outcomes of this growing group of people and can be used to inform the advice given to those contemplating fertility preservation in the context of cancer.

STUDY FUNDING/COMPETING INTERESTS

The study was funded by the National Health and Medical Research Council (APP1042347). The authors have no conflicts of interest to declare.

TRIAL REGISTRATION NUMBER

Not applicable.

Authors+Show Affiliations

Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia. Victorian Assisted Reproductive Treatment Authority, Victoria, Australia.Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.Melbourne IVF, Victoria, Australia. Reproductive Services, Royal Women's Hospital and Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia.Monash IVF, Victoria, Australia. Andrology Australia, Victoria, Australia. Hudson Institute, Monash Medical Centre, Victoria, Australia.Royal Women's Hospital, University of Melbourne, Victoria, Australia.Melbourne IVF, Victoria, Australia.Melbourne IVF, Victoria, Australia. Reproductive Services, Royal Women's Hospital and Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia.Monash IVF, Victoria, Australia. Hudson Institute, Monash Medical Centre, Victoria, Australia. Monash Health, Monash Medical Centre, Victoria, Australia. Department of Obstetrics and Gynaecology, Monash University, Victoria, Australia.Monash IVF, Victoria, Australia. Monash Health, Monash Medical Centre, Victoria, Australia. Department of Obstetrics and Gynaecology, Monash University, Victoria, Australia.Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29045667

Citation

Hammarberg, K, et al. "Survey of Reproductive Experiences and Outcomes of Cancer Survivors Who Stored Reproductive Material Before Treatment." Human Reproduction (Oxford, England), vol. 32, no. 12, 2017, pp. 2423-2430.
Hammarberg K, Kirkman M, Stern C, et al. Survey of Reproductive Experiences and Outcomes of Cancer Survivors Who Stored Reproductive Material Before Treatment. Hum Reprod. 2017;32(12):2423-2430.
Hammarberg, K., Kirkman, M., Stern, C., McLachlan, R. I., Clarke, G., Agresta, F., Gook, D., Rombauts, L., Vollenhoven, B., & Fisher, J. R. W. (2017). Survey of Reproductive Experiences and Outcomes of Cancer Survivors Who Stored Reproductive Material Before Treatment. Human Reproduction (Oxford, England), 32(12), 2423-2430. https://doi.org/10.1093/humrep/dex314
Hammarberg K, et al. Survey of Reproductive Experiences and Outcomes of Cancer Survivors Who Stored Reproductive Material Before Treatment. Hum Reprod. 2017 Dec 1;32(12):2423-2430. PubMed PMID: 29045667.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Survey of Reproductive Experiences and Outcomes of Cancer Survivors Who Stored Reproductive Material Before Treatment. AU - Hammarberg,K, AU - Kirkman,M, AU - Stern,C, AU - McLachlan,R I, AU - Clarke,G, AU - Agresta,F, AU - Gook,D, AU - Rombauts,L, AU - Vollenhoven,B, AU - Fisher,J R W, PY - 2017/06/26/received PY - 2017/09/27/accepted PY - 2017/10/19/pubmed PY - 2018/10/12/medline PY - 2017/10/19/entrez KW - cancer KW - fertility preservation KW - oocyte cryopreservation KW - pregnancy KW - sperm cryopreservation SP - 2423 EP - 2430 JF - Human reproduction (Oxford, England) JO - Hum. Reprod. VL - 32 IS - 12 N2 - STUDY QUESTION: What are the reproductive experiences and outcomes of people who store reproductive material before cancer treatment? SUMMARY ANSWER: Of respondents who had tried to achieve pregnancy since completing cancer treatment almost all had succeeded, in most cases through natural conception. WHAT IS KNOWN ALREADY: People of reproductive age who are diagnosed with cancer can cryopreserve reproductive material to guard against the adverse effects on fertility of gonadotoxic treatment. Little is known about the reproductive outcomes of people who undergo fertility preservation before cancer treatment. STUDY DESIGN, SIZE, DURATION: Cross-sectional survey. PARTICIPANTS/MATERIALS, SETTING, METHODS: Women and men who had stored reproductive material before cancer treatment at two private and one public fertility clinics up to June 2014 and were at least 18 years old at the time were identified from medical records and invited to complete an anonymous questionnaire about their reproductive experiences. MAIN RESULTS AND THE ROLE OF CHANCE: Of the 870 potential respondents 302 (171 female and 131 male) returned completed questionnaires yielding a response rate of 34.5% (39.5% and 29.7% for female and male respondents, respectively). Current age was similar for women and men (37.2 years) but men had been diagnosed with cancer significantly earlier in life than women (28.2 versus 30.3 years, P = 0.03). Almost two-thirds of respondents wished to have a child or another child in the future, some of whom knew that they were unable to. One in ten respondents was a parent before the cancer diagnosis and around one-third had had a child since diagnosis or was pregnant (or a partner in pregnancy) at the time of the survey. Of those who had tried to conceive since completing cancer treatment (N = 119) 84% (79% of women and 90% of men) had had a child or were pregnant (or a partner in pregnancy). Most of the pregnancies since the diagnosis of cancer occurred after natural conception (58/100, 58%). Of the 22 women (13% of all women) and 35 men (27% of all men) who had used their stored reproductive material four women (18%) and 28 men (80%) had had a child or were pregnant or a partner in pregnancy at the time of completing the survey. The most commonly stated reason for not using the stored material was not being ready to try for a baby. LIMITATIONS, REASON FOR CAUTION: The relatively low response rate, particularly among men, means that participation bias may have influenced the findings. As type of cancer was self-reported and we did not ask questions about respondents' cancer treatments, it is not possible to link reproductive outcomes to type of cancer or cancer treatment. Also, there is no way of comparing the sample with the populations they were drawn from as data on reproductive outcomes of people who store reproductive material before cancer treatment are not collected routinely. This might have led to over- or underestimates of the reproductive experiences and outcomes reported in this paper. WIDER IMPLICATIONS OF THE FINDINGS: The findings add to the limited evidence about the reproductive outcomes of this growing group of people and can be used to inform the advice given to those contemplating fertility preservation in the context of cancer. STUDY FUNDING/COMPETING INTERESTS: The study was funded by the National Health and Medical Research Council (APP1042347). The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER: Not applicable. SN - 1460-2350 UR - https://www.unboundmedicine.com/medline/citation/29045667/Survey_of_Reproductive_Experiences_and_Outcomes_of_Cancer_Survivors_Who_Stored_Reproductive_Material_Before_Treatment_ L2 - https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/dex314 DB - PRIME DP - Unbound Medicine ER -