Assisted reproductive technology use and outcomes among women with a history of cancer

• DOI: 10.1093/humrep/dev288
• Publication Date: 2015-11-18T02:23:13Z
• Authors: Barbara Luke; Morton B. Brown; Stacey A. Missmer; Logan G. Spector; Richard E. Leach; Melanie Williams; Lori Koch; Yolanda R. Smith; Judy E. Stern; G. David Ball; Maria J. Schymura
• Keywords: Assisted Reproductive Technology; Live birth

How do the assisted reproductive technology (ART) outcomes of women presenting for ART after cancer diagnosis compare to without cancer? The likelihood a live birth among with prior using autologous oocytes is reduced and varies by but similar when donor are used. Premenopausal patients faced frequently present fertility preservation. Population-based cohort study treated in NY, TX IL, USA. Women their first treatment between 2004 2009 were identified from Society Assisted Reproductive Technology Clinic Outcome Reporting System database linked respective State Cancer Registries based on name, date social security number. Years rounded, i.e. year 1 = 6–18 months before treatment. This used reports 5 years, 6 until who only presented embryo banking omitted analysis. pregnancy was modeled logistic regression, as reference group, adjusted woman's age, parity, cumulative FSH dosage, infertility diagnosis, number diagnoses, cycles, residency Results modeling reported odds ratios (AORs) (95% confidence intervals). population included 53 426 women; 441 diagnosed within years cycle start. Mean (±SD) age at 33.4 ± 5.7 years; start 34.9 5.8 compared 35.3 5.3 (P 0.03). Live rates differed substantially status (47.7% versus 24.7% cancer, P < 0.0001), (ranging 53.5% melanoma 14.3% breast 0.0001. did not vary significantly (60.4% any 64.5% cancer), or 57.9% 63.6% endocrine cancer). make up about one-third all cancers this cohort. Among 2.8% 106 underwent being 34.8% 46 received longer time 0.0001). We conjecture that former group either unaware they had decided undergo therapy However, rate 11.7% 28.8%, overall more than (23.3%) differ 0.49). If difference substantiated larger study, it would indicate negative effect severe recent illness itself success, rather poor outcome related destructive effects chemotherapies ovarian follicles. Alternatively, because short treatment, these pre-existing may have been detected due increased medical surveillance during therapy. In oocytes, less likely become pregnant those (adjusted ratio (AOR): 0.34, [95% interval (CI): 0.27, 0.42] 0.36 [0.28, 0.46], respectively). also evident specific diagnoses: (0.20 [0.13, 0.32] 0.19 [0.11, 0.30], respectively), cervical (0.36 [0.15, 0.87] 0.33 0.84], respectively) female genital (0.49 [0.27, 0.47 [0.25, 0.86], Of note, became pregnant, having (85.8 86.7% 85.3 86.9% oocytes). residents individual States entire 5-year pre-ART period, therefore some through linkage. As result, actual observed be an underestimate. addition, prevalence low distributions. Also, we restricted period prior, survivors early childhood (younger 13 diagnosis), cancer. Additional analyses currently underway evaluating ART, cycles which excluded paper. Future studies planned will include States, well linkages vital records obtain information spontaneous conceptions births, further clarify issues raised Since suggests factors acting pre- peri-conceptional periods responsible decline. funded grant R01 CA151973 National Institute, Institutes Health, B.L. research consultant Technology. All other authors report no conflict interest.