Female cancer survivors are 38 percent less likely to become pregnant compared with women in the general population, according to a study presented at the annual European Society of Human Reproduction and Embryology conference in Geneva.
Professor Richard Anderson at Edinburgh University, UK, and his team studied pregnancy rates in 23,201 female cancer survivors of reproductive age on the Scottish Cancer Registry and matched controls, over a 30-year-period. They found that 29 percent of cancer survivors achieved pregnancy, compared with 46 percent in the control group.
Reduction in fertility after cancer is often attributed to the effects of chemotherapy and radiotherapy.
Chemotherapy 'could add a decade to a women’s reproductive age', commented Dr Gillian Lockwood, medical director of IVI Midland in Tamworth, UK. She emphasised the importance of accurate and comprehensive patient counselling.
Professor Anderson stressed that the results of his study only measure pregnancy post- cancer diagnosis, and do not indicate incidence of infertility. He explained that 'some women may have chosen not to have a pregnancy' and 'having a pregnancy after cancer does involve a range of complex issues…' No increased risk of miscarriage or stillbirth was found.
The impact of cancer was more pronounced when it came to first pregnancies, with an almost 50 percent reduction in likelihood of a first pregnancy for women post-diagnosis compared with the control group. A reduction in pregnancies was observed in all types of cancer, but the largest effects occurred in survivors of breast and cervical cancer, and leukaemia.
The study highlights the need for renewed focus on fertility preservation, both in terms of driving forward further development in the field, as well as ensuring that there is consistent access to these medical interventions across the world. Professor Anderson described current fertility preservation services as 'very variable', even in the USA and Europe.
In 2016, Professor Anderson led the team which successfully re-implanted a section of ovarian tissue into an infertile cancer survivor, a decade after the tissue had been extracted. She gave birth to a healthy baby boy, becoming one of only a handful of women in the world to give birth after an ovarian tissue cryopreservation procedure, and the first in the UK.
While emphasising that this is very much an experimental procedure, Professor Anderson added: 'It comes at a time when NHS services for fertility preservation are developing across the UK, and we hope it will be the impetus to provide that to all who are in need.'