Young female cancer survivors not clear on infertility risks

(Reuters Health) - Many young women who survive cancer don’t understand how tumor treatments affect their reproductive health even though the therapy can trigger infertility, a survey suggests.

Researchers focused on 346 women who were around 30 years old on average and had typically finished cancer treatment about five years earlier.

At the time participants completed the survey, 106 women said they had been told they would not be able to become pregnant or carry a baby to term as a result of their cancer treatment, and 21 women said they had taken steps to preserve fertility before treatment such as egg or embryo freezing.

Another 179 women said they maybe or definitely wanted children but didn’t know their fertility status and hadn’t done anything to preserve fertility.

“It is difficult to predict with certainty how any one woman’s fertility will be affected by the cancer treatment she receives,” said lead study author Dr. Catherine Benedict of Northwell Health in Great Neck, New York.

“Many women will maintain fertility after treatment but will experience menopause and infertility at an early age, with no certainty about when this may occur,” Benedict added by email.

The most common diagnoses were lymphoma – tumors of the lymphatic system that fights disease in the body, breast cancer, and leukemia – malignancies of the bone marrow and blood-forming tissues.

Among the subset of women unsure about their fertility status, almost two-thirds said they were concerned that they might not be able to have children in the future, 41 percent reported it was stressful to think about getting pregnant, and 59 percent were worried about passing on a genetic risk for cancer.

At the same time, only 13 percent of these women believed they were informed about their fertility preservation options, Benedict and her coauthors - all from Memorial Sloan-Kettering Cancer Center in New York City - report in the journal Cancer.

One limitation of the study is that it was done online and researchers didn’t independently verify participants’ responses or medical records, the authors note.

Still, the findings underscore the importance of addressing fertility issues so that cancer patients can make informed decisions about their reproductive options, the authors conclude.

Before treatment, women should ask what is known about the drugs or treatments they’re about to receive in terms of the likelihood of damage to ovaries and eggs, said Dr. Kutluk Oktay, director of the Innovation Institute for Fertility Preservation and IVF in New York.

Patients should also ask for a referral to a specialist who can discuss the fertility implications of treatment and options to preserve fertility, Oktay, who wasn’t involved in the study, added by email.

“Depending on the patient’s age and available time as well as cancer type, embryo, egg, or ovarian tissue freezing or a combination of those can be offered,” he said.

Some patients may still not consider fertility preservation because of concerns about the safety of delaying cancer treatment or due to costs or lack of insurance coverage, Oktay noted. But women should have all the facts before they decide.

SOURCE: Cancer, online May 23, 2016.