Ovarian failure risk in post-pubertal patients with cancer: a prognostic model

Cioffi, Raffaella; Fais, Maria Luisa; Bergamini, Alice; Vanni, Valeria Stella; Pagliardini, Luca; Papaleo, Enrico; Mangili, Giorgia; Candiani, Massimo

doi:10.2217/fon-2022-0078

Cited by 6 publications

(6 citation statements)

References 23 publications

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“…For women, chemotherapy, especially cyclophosphamide and procarbazine, have effects on the loss of ovarian reserve, which can cause lesions in the ovarian stroma [31][32][33].…”

Section: Chemotherapymentioning

confidence: 99%

Oncofertility in pediatric patients: current perspectives

Marques¹,

Oura

Dionísio³

et al. 2022

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Cancer treatments may affect fertility in different ways. Oncofertility, i.e. the study of interactions between cancer, anti-cancer therapy, fertility, and reproductive health, is an emerging field that addresses cancer patients' concerns regarding their future reproductive ability. As the number of cancer survivors increases, fertility preservation is becoming an important quality of life issue for many survivors of childhood cancer. There is a wide array of fertility preservation options according to gender and pubertal status, and shared decisions must take place at the time of diagnosis. Even though there might be several barriers that can negatively affect this process, the presence of a dedicated fertility preservation team may help overcome them. In this article, the authors aim to characterize what oncofertility is, the effects of cancer and its treatments on the fertility potential of pediatric patients and also on their mental health. Another goal is to expose the different fertility preservation therapeutic options and potential barriers.

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“…For women, chemotherapy, especially cyclophosphamide and procarbazine, have effects on the loss of ovarian reserve, which can cause lesions in the ovarian stroma [31][32][33].…”

Section: Chemotherapymentioning

confidence: 99%

Oncofertility in pediatric patients: current perspectives

Marques¹,

Oura

Dionísio³

et al. 2022

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“…19,22,23 Experiments have been conducted to develop tools for assessing the risk of POI in post-pubertal women after chemotherapy, but these tools are not widely used. 24 Although several studies have assessed the risk of childhood cancer survivors developing POI, our knowledge of the prevalence of cancer before POI is limited. Therefore, we aimed to conduct a population-based nationwide study to explore the odds ratio (OR) of previous cancer in women with POI compared with age-matched controls stratified by age at cancer diagnosis and the interval between cancer and POI.…”

Section: Introductionmentioning

confidence: 99%

“…Specific cancer treatments, such as radiotherapy of the ovaries, high‐dose alkylating agents, or hematopoietic stem cell transplantation, have been associated with a high risk of POI 19,22,23 . Experiments have been conducted to develop tools for assessing the risk of POI in post‐pubertal women after chemotherapy, but these tools are not widely used 24 …”

Section: Introductionmentioning

confidence: 99%

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Previous cancers in women diagnosed with premature ovarian insufficiency: A nationwide population‐based case–control study

Silvén,

Savukoski,

Pesonen

et al. 2024

Acta Obstet Gynecol Scand

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IntroductionTo investigate the occurrence of previous cancer diagnoses in women suffering from premature ovarian insufficiency (POI) and compare it with the general population, shedding light on the association between cancer, cancer treatments, and POI.Material and methodsWe conducted a nationwide case–control study based on registry data from various sources, including the Social Insurance Institution, Finnish Population Information System, and Finnish Cancer Registry spanning from 1953 to 2018. Our subjects comprised all women in Finland who, between 1988 and 2017, received hormone replacement therapy reimbursement for ovarian insufficiency before the age of 40 years (n = 5221). Controls, matched in terms of age and municipality of residence, were selected from the Finnish Population Information System (n = 20 822). Our main exposure variable was a history of cancer diagnosis preceding the diagnosis of POI. We analyzed odds ratios (OR) to compare the prevalence of previous cancers in women with POI with that in controls, stratifying results based on cancer type, age at cancer diagnosis, and the time interval between cancer diagnosis and POI. We also assessed changes in OR for previous cancer diagnoses over the follow‐up period.ResultsOut of the women diagnosed with POI, 21.9% had previously been diagnosed with cancer, resulting in an elevated OR of 36.5 (95% confidence interval [CI] 30.9 to 43.3) compared with 0.8% of the controls. The risk of developing POI was most pronounced during the first 2 years following a cancer diagnosis, with an OR of 103 (95% CI 74.1 to 144). Importantly, this risk remained elevated even when the time interval between cancer and POI exceeded 10 years, with an OR of 5.40 (95% CI 3.54 to 8.23).ConclusionsThis study reveals that 21.9% of women with POI have a history of cancer, making the prevalence of cancer among these women 27.5 times higher than age‐matched controls in the Finnish population. The risk of developing POI is most substantial in the first 2 years following a cancer diagnosis. These findings underscore the role of cancer treatments as an etiological factor for POI and emphasize the importance of recognizing the risk of POI in cancer survivors for early diagnosis and intervention.

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“…Frequently in high-risk cases, the mainstay of systemic treatment consists of intensive alkylating agent-based multidrug chemotherapy [ 4 ], which is known to be extremely gonadotoxic. Many female patients treated with chemotherapy and pelvic radiotherapy for a diagnosis of sarcoma experience premature ovarian insufficiency (POI) and impaired fertility later in life as a consequence of treatment [ 5 ]. It is estimated that, as a result of gonadotoxic treatments, at least one-third of the female cancer population undergoes POI [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Response to Controlled Ovarian Stimulation Is Not Impaired in Young Patients with a Sarcoma: Results from a Monocentric Case–Control Study

Cioffi

Pagliardini

Quartucci

et al. 2023

Cancers

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Sarcomas are relatively common in the young and their treatment can impair fertility. Fertility preservation can be achieved via the cryopreservation of gametes after controlled ovarian stimulation before cancer treatment. A reduced response to hormonal stimulation in patients suffering from certain types of malignancy is reported. The purpose of this study was to assess the performance of oocyte cryopreservation in patients with sarcoma by comparing their outcomes with those of a population without cancer. Patients were matched by age with control women undergoing hormonal stimulation for isolated male factor infertility. The population included 84 women with a sarcoma and 355 controls. In the final analysis, 37 patients with sarcoma were matched in a 1:3 ratio with 109 healthy controls. Patients with sarcoma were generally younger and were stimulated with lower FSH doses. They did not perform worse than controls during stimulation, with an average retrieval of 10.6 oocytes vs. 8.1 in the controls. Linear regression on the number of retrieved mature oocytes confirmed that patients with sarcoma performed comparably to controls. In conclusion, patients with sarcoma can expect retrieval outcomes comparable to those of patients without cancer.

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Ovarian failure risk in post-pubertal patients with cancer: a prognostic model

Cited by 6 publications

References 23 publications

Oncofertility in pediatric patients: current perspectives

Oncofertility in pediatric patients: current perspectives

Previous cancers in women diagnosed with premature ovarian insufficiency: A nationwide population‐based case–control study

Response to Controlled Ovarian Stimulation Is Not Impaired in Young Patients with a Sarcoma: Results from a Monocentric Case–Control Study

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