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Reproductive health in female survivors of childhood cancer
Author(s) -
Gelson Emily,
Prakash Alka,
Macdougall Jane,
Williams Denise
Publication year - 2016
Publication title -
the obstetrician and gynaecologist
Language(s) - English
Resource type - Journals
eISSN - 1744-4667
pISSN - 1467-2561
DOI - 10.1111/tog.12338
Subject(s) - medicine , cancer , fertility , childhood cancer , pregnancy , life expectancy , cancer survivor , ovarian cancer , pediatrics , gynecology , environmental health , population , biology , genetics
Key content Over the past four decades childhood cancer diagnosis has increased throughout Europe. Long‐term survival rates have reached 80% and it is estimated that there are currently more than 33 000 survivors of childhood cancer alive in the UK. Despite such successes, a significant number of childhood cancer survivors experience late chronic adverse effects of their treatment. The major effect on reproductive health is subfertility due to potential acute ovarian failure and premature menopause. Late effects on cardiac, renal, and pulmonary function can compromise pregnancy. As such, careful prepregnancy counselling and planning is paramount.Learning objectives Understand the potential effects of childhood cancer treatments on reproductive function. Understand how to assess ovarian reserve in female survivors of childhood cancer. Understand the potential systemic long‐term effects of cancer treatment during childhood and the relevance to childbearing.Ethical issues Should in vitro fertilisation (IVF) be performed in women with a past history of cancer, considering their reduced life expectancy and the potential chronic late effects of treatment? When should an adolescent who has survived cancer be made aware that their fertility may be compromised?