Reproductive outcomes following treatment for a gynecological cancer diagnosis: a systematic review

Brigitte Gerstl, Elizabeth Sullivan, Marcus Vallejo, Jana Koch, Maximilian Johnson, Handan Wand, Kate Webber, Angela Ives, Antoinette Anazodo

Research output: Contribution to journalReview article

Abstract

PurposeFertility treatments are available for women diagnosed with a gynecological malignancy, which is important for women who desire a biological family subsequent to treatment. The objective of this study was to report reproductive outcomes following fertility-sparing treatment for a gynaecological cancer.MethodsElectronic databases were searched to identify studies that reported on reproductive outcomes after treatment for a gynecological malignancy.ResultsIn total, 77 studies were included which reported on reproductive outcomes after treatment for cervical cancer, endometrial cancer, gestational trophoblastic disease, and ovarian cancer. The main treatments included vaginal or abdominal radical trachelectomy, progestin therapy, salpingo-oophorectomy, and chemotherapy. The mean age at diagnosis for the study population and at birth were 30.5years and 30.3years, respectively. There were 4749 pregnancies (42%) reported for the included studies, with a miscarriage rate of 15% and a medical termination rate of 5%. The live birth rate was 74% with a 10% preterm rate.Implications for Cancer SurvivorsPatients should be offered timely discussions, information, and counseling regarding the impact of gynecological cancer treatment on a patient's fertility. Furthermore, fertility-sparing strategies and fertility preservation should be discussed prior to starting treatment.

Original languageEnglish
Pages (from-to)269-281
Number of pages13
JournalJournal of Cancer Survivorship
Volume13
Issue number2
DOIs
Publication statusPublished - Apr 2019

Cite this

Gerstl, B., Sullivan, E., Vallejo, M., Koch, J., Johnson, M., Wand, H., ... Anazodo, A. (2019). Reproductive outcomes following treatment for a gynecological cancer diagnosis: a systematic review. Journal of Cancer Survivorship, 13(2), 269-281. https://doi.org/10.1007/s11764-019-00749-x
Gerstl, Brigitte ; Sullivan, Elizabeth ; Vallejo, Marcus ; Koch, Jana ; Johnson, Maximilian ; Wand, Handan ; Webber, Kate ; Ives, Angela ; Anazodo, Antoinette. / Reproductive outcomes following treatment for a gynecological cancer diagnosis : a systematic review. In: Journal of Cancer Survivorship. 2019 ; Vol. 13, No. 2. pp. 269-281.
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Gerstl, B, Sullivan, E, Vallejo, M, Koch, J, Johnson, M, Wand, H, Webber, K, Ives, A & Anazodo, A 2019, 'Reproductive outcomes following treatment for a gynecological cancer diagnosis: a systematic review' Journal of Cancer Survivorship, vol. 13, no. 2, pp. 269-281. https://doi.org/10.1007/s11764-019-00749-x

Reproductive outcomes following treatment for a gynecological cancer diagnosis : a systematic review. / Gerstl, Brigitte; Sullivan, Elizabeth; Vallejo, Marcus; Koch, Jana; Johnson, Maximilian; Wand, Handan; Webber, Kate; Ives, Angela; Anazodo, Antoinette.

In: Journal of Cancer Survivorship, Vol. 13, No. 2, 04.2019, p. 269-281.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Reproductive outcomes following treatment for a gynecological cancer diagnosis

T2 - a systematic review

AU - Gerstl, Brigitte

AU - Sullivan, Elizabeth

AU - Vallejo, Marcus

AU - Koch, Jana

AU - Johnson, Maximilian

AU - Wand, Handan

AU - Webber, Kate

AU - Ives, Angela

AU - Anazodo, Antoinette

PY - 2019/4

Y1 - 2019/4

N2 - PurposeFertility treatments are available for women diagnosed with a gynecological malignancy, which is important for women who desire a biological family subsequent to treatment. The objective of this study was to report reproductive outcomes following fertility-sparing treatment for a gynaecological cancer.MethodsElectronic databases were searched to identify studies that reported on reproductive outcomes after treatment for a gynecological malignancy.ResultsIn total, 77 studies were included which reported on reproductive outcomes after treatment for cervical cancer, endometrial cancer, gestational trophoblastic disease, and ovarian cancer. The main treatments included vaginal or abdominal radical trachelectomy, progestin therapy, salpingo-oophorectomy, and chemotherapy. The mean age at diagnosis for the study population and at birth were 30.5years and 30.3years, respectively. There were 4749 pregnancies (42%) reported for the included studies, with a miscarriage rate of 15% and a medical termination rate of 5%. The live birth rate was 74% with a 10% preterm rate.Implications for Cancer SurvivorsPatients should be offered timely discussions, information, and counseling regarding the impact of gynecological cancer treatment on a patient's fertility. Furthermore, fertility-sparing strategies and fertility preservation should be discussed prior to starting treatment.

AB - PurposeFertility treatments are available for women diagnosed with a gynecological malignancy, which is important for women who desire a biological family subsequent to treatment. The objective of this study was to report reproductive outcomes following fertility-sparing treatment for a gynaecological cancer.MethodsElectronic databases were searched to identify studies that reported on reproductive outcomes after treatment for a gynecological malignancy.ResultsIn total, 77 studies were included which reported on reproductive outcomes after treatment for cervical cancer, endometrial cancer, gestational trophoblastic disease, and ovarian cancer. The main treatments included vaginal or abdominal radical trachelectomy, progestin therapy, salpingo-oophorectomy, and chemotherapy. The mean age at diagnosis for the study population and at birth were 30.5years and 30.3years, respectively. There were 4749 pregnancies (42%) reported for the included studies, with a miscarriage rate of 15% and a medical termination rate of 5%. The live birth rate was 74% with a 10% preterm rate.Implications for Cancer SurvivorsPatients should be offered timely discussions, information, and counseling regarding the impact of gynecological cancer treatment on a patient's fertility. Furthermore, fertility-sparing strategies and fertility preservation should be discussed prior to starting treatment.

KW - Gynecological neoplasms

KW - Survivors

KW - Pregnancy

KW - Oncofertility

KW - Systematic review

KW - GESTATIONAL TROPHOBLASTIC DISEASE

KW - BREAST-CANCER

KW - PREGNANCY OUTCOMES

KW - RADICAL TRACHELECTOMY

KW - CONSENSUS GUIDELINES

KW - CERVICAL-CANCER

KW - PRIMARY THERAPY

KW - CHEMOTHERAPY

KW - FERTILITY

KW - WOMEN

U2 - 10.1007/s11764-019-00749-x

DO - 10.1007/s11764-019-00749-x

M3 - Review article

VL - 13

SP - 269

EP - 281

JO - Journal of cancer survivorship : research and practice

JF - Journal of cancer survivorship : research and practice

SN - 1932-2259

IS - 2

ER -