Fertility in female cancer survivors: a systematic review and meta-analysis

Busnelli, Andrea; Vitagliano, Amerigo; Mensi, Laura; Acerboni, S; Bulfoni, A; Filippi, Francesca; Somigliana, Edgardo

doi:10.1016/j.rbmo.2020.02.008

Cited by 17 publications

(9 citation statements)

References 90 publications

(240 reference statements)

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“…TC treatment impairs the normal thyroid function, which may affect the implantation and pregnancy outcomes. Previous studies have investigated whether a history of TC treatment affects the chances of pregnancy and a meta-analysis conducted by Busnelli et al failed to show that TC treatment had any influence [19]. However, studies focused on the effect of a history of TC on pregnancy outcomes after IVF/ICSI are lacking.…”

Section: Discussionmentioning

confidence: 99%

Analysis of in vitro fertilization/intracytoplasmic sperm injection outcomes in infertile women with a history of thyroid cancer: a retrospective study

Zeng

Yan

Chi

et al. 2021

Reprod Biol Endocrinol

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Background Recent studies have revealed that women with infertility have a higher risk of thyroid cancer (TC) than fertile women. However, studies on whether a history of thyroid cancer affects clinical outcomes in women who conceive using in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) are scarce. We investigate whether a history of thyroid cancer (TC) affects the in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes and increases the risk of adverse obstetric outcomes in women with infertility. Methods This retrospective study enrolled 384 women with infertility who underwent their first IVF/ICSI treatment at the Peking University Third Hospital between 2010 and 2019. Participants were divided into the TC (64 women with TC history) and control (320 women matched from 85,272 women without thyroid diseases) groups. Controls were individually matched to the TC group according to age, body mass index, concomitant infertility factors, first IVF/ICSI dates, and controlled ovarian stimulation and embryo transfer procedure protocols. IVF/ICSI outcomes, including the numbers of retrieved oocytes and high-grade embryos, clinical pregnancy, miscarriage, preterm delivery, and live birth rates, and adverse obstetric outcome risk were assessed. Results The TC group had significantly higher thyroid hormone and lower thyroid-stimulating hormone (TSH) levels than the control group. Despite similar gonadotropin treatment dosage, the TC group had a significantly lower numbers of retrieved oocytes and high-grade embryos than the control group. The occurrence rates of clinical pregnancy, miscarriage, preterm delivery, live births, and adverse obstetric outcomes, including multiple gestation, preterm delivery, gestational diabetes mellitus, gestational hypertension, low birth weight, and large-for-gestational-age infants, were not significantly different between the two groups. Conclusions TC history did not affect the pregnancy outcomes or increase the risk of adverse obstetric outcomes after the first IVF/ICSI, but it may decrease the number of retrieved oocytes and high-grade embryos.

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Section: Discussionmentioning

confidence: 99%

Analysis of in vitro fertilization/intracytoplasmic sperm injection outcomes in infertile women with a history of thyroid cancer: a retrospective study

Zeng

Yan

Chi

et al. 2021

Reprod Biol Endocrinol

View full text Add to dashboard Cite

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“…Results are expressed as incidence rate ratio, relative risk or odds ratio with 95% confidence interval. The calculated and extracted effect estimates were combined in meta-analyses using the generic inverse variance method, with the DerSimonian and Laird randomeffects model (DerSimonian and Kacker, 2007;Busnelli et al, 2020). The effect estimates were combined as they were extrapolated from the studies and no attempts were made to convert one effect estimate into another.…”

Section: Methodsmentioning

confidence: 99%

Fibroids and natural fertility: a systematic review and meta-analysis

Somigliana

Reschini

Bonanni

et al. 2021

Reproductive BioMedicine Online

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“…A recently published meta-analysis investigating fertility in female cancer survivors across various cancer types stated that reproductive chances in women surviving melanoma were rather unaffected. 54 However, the two studies including melanoma patients were from 2011 and 2013, before the era of routine clinical use of ICI and BRAF/MEK inhibition. Hence, to date, we cannot exclude an effect on female and/or male fertility by these treatments.…”

Section: Recommendationsmentioning

confidence: 99%

Fertility preservation and management of pregnancy in melanoma patients requiring systemic therapy

et al. 2021

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Melanoma is one of the most common cancers in adolescents and adults at fertile age, especially in women. With novel and more effective systemic therapies that began to profoundly change the dismal outcome of melanoma by prolonging overall survival, the wish for fertility preservation or even parenthood has to be considered for a growing portion of melanoma patients—from the patients' as well as from the physicians' perspective. The dual blockade of the mitogen-activated protein kinase pathway by B-Raf proto-oncogene serine/threonine kinase and mitogen-activated protein kinase inhibitors and the immune checkpoint inhibition by anti-programmed cell death protein 1 and anti-cytotoxic T-lymphocyte-associated protein-4 monoclonal antibodies constitute the current standard systemic approaches to combat locally advanced or metastatic melanoma. Here, the preclinical data and clinical evidence of these systemic therapies are reviewed in terms of their potential gonadotoxicity, teratogenicity, embryotoxicity and fetotoxicity. Recommendations for routine fertility and contraception counseling of melanoma patients at fertile age are provided in line with interdisciplinary recommendations for the diagnostic work-up of these patients and for fertility-protective measures. Differentiated recommendations for the systemic therapy in both the adjuvant and the advanced, metastatic treatment situation are given. In addition, the challenges of pregnancy during systemic melanoma therapy are discussed.

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Fertility in female cancer survivors: a systematic review and meta-analysis

Abstract: Women with a history of bone, breast, brain or kidney cancer have reduced chances of childbirth compared with unaffected controls. On the contrary, thyroid cancer, melanoma and Non-Hodgkin's lymphoma survivors can be reassured about their reproductive prognosis.

Cited by 17 publications

References 90 publications

Analysis of in vitro fertilization/intracytoplasmic sperm injection outcomes in infertile women with a history of thyroid cancer: a retrospective study

Analysis of in vitro fertilization/intracytoplasmic sperm injection outcomes in infertile women with a history of thyroid cancer: a retrospective study

Fibroids and natural fertility: a systematic review and meta-analysis

Fertility preservation and management of pregnancy in melanoma patients requiring systemic therapy

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