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International Journal of Clinical Oncology

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Open Access 01-06-2020 | Fertility | Original Article

Fertility preservation and fulfillment of parenthood after treatment of hematological malignancies: results from the ‘Aftercare in Blood Cancer Survivors’ (ABC) study

Authors: Christine Schmitz, Julia Baum, Hildegard Lax, Nils Lehmann, Tanja Gromke, Dietrich W. Beelen, K.-H. Jöckel, Ulrich Dührsen

Published in: International Journal of Clinical Oncology | Issue 6/2020

Abstract

Purpose

Treatment of hematological malignancies carries the risk of lasting sterility. We aimed to identify fertility-related unmet needs.

Methods

The ‘Aftercare in Blood Cancer Survivors’ study is a cohort study of hematological patients who were in treatment-free remission for ≥ 3 years or stable under continuous oral medication. Female patients age 18–45 years and male patients age 18–65 years without a history of pre-treatment infertility were asked to answer a structured questionnaire including questions addressing fertility issues. Multivariable analyses were performed to detect risk factors.

Results

Of 1562 study participants, 1031 met the inclusion criteria for the fertility sub-study. A high proportion of patients (72.4%) received information about the risk of losing fertility, but only a minority (15%) took steps to preserve it. Female and older patients were less likely to be informed. A post-treatment wish for parenthood was expressed by 19.3% of patients. It was strongly associated with childlessness at time of diagnosis and could be fulfilled by 29.4%. Fulfillment of desired parenthood increased with increasing time from diagnosis and was low after allogeneic transplantation.

Conclusions

Female and older hematological patients are less likely to be informed about fertility-related issues than other patients. With societal changes towards first parenthood at higher age, the proportion of patients desiring a child after treatment is likely to increase. Fulfillment of desired parenthood remains challenging, especially after allogeneic transplantation.

Implications for cancer survivors

In patients likely to express a wish for post-treatment parenthood, fertility-related issues should routinely be addressed before gonadotoxic treatment is started.

Available only for authorised users

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Title: Fertility preservation and fulfillment of parenthood after treatment of hematological malignancies: results from the ‘Aftercare in Blood Cancer Survivors’ (ABC) study
Authors: Christine Schmitz
Julia Baum
Hildegard Lax
Nils Lehmann
Tanja Gromke
Dietrich W. Beelen
K.-H. Jöckel
Ulrich Dührsen
Publication date: 01-06-2020
Publisher: Springer Singapore
Keywords: Fertility
Infertility
Infertility
Published in: International Journal of Clinical Oncology / Issue 6/2020
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-020-01639-4

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Abstract

Purpose

Methods

Results

Conclusions

Implications for cancer survivors

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