Decreased fertility among female childhood cancer survivors who received 22-27 Gy hypothalamic/pituitary irradiation: a report from the Childhood Cancer Survivor Study.

Abstract

OBJECTIVE:

To evaluate the effect of hypothalamic/pituitary radiation (HPT RT) dose on the occurrence of first pregnancy.

DESIGN:

Retrospective cohort study of childhood cancer 5-year survivors (CCS) diagnosed between 1970 and 1986 before 21 years of age at one of 26 North American pediatric cancer treatment centers.

SETTING:

Self-administered questionnaire.

PATIENT(S):

A total of 3,619 female CCS who participated in the Childhood Cancer Survivor Study and received no or scatter (≤0.1 Gy) radiation to the ovaries and 2,081 female siblings (Sibs) of the participants.

INTERVENTION(S):

None.

MAIN OUTCOME MEASURE(S):

Self-reported pregnancy events.

RESULT(S):

As a group, CCS were as likely to report being pregnant as Sibs (hazard ratio 1.07, 95% confidence interval 0.97-1.19). Multivariable models showed a significant decrease in the risk of pregnancy with HPT RT doses≥22 Gy compared with those CCS receiving no HPT RT.

CONCLUSION(S):

These results support the hypothesis that exposures of 22-27 Gy HPT RT may be a contributing factor to infertility among female CCS.

• Authors: Daniel M Green, Vikki G Nolan, Toana Kawashima, Marilyn Stovall, Sarah S Donaldson, DeoKumar Srivastava, Wendy Leisenring, Leslie L Robison, Charles A Sklar
• Journal: Fertility and sterility (Fertil Steril) Vol. 95 Issue 6 Pg. 1922-7, 1927.e1 (May 2011) ISSN: 1556-5653 [Electronic] United States
• PMID: 21376314 (Publication Type: Evaluation Study, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Topics

• Age of Onset
• Child
• Cohort Studies
• Female
• Humans
• Hypothalamus (pathology, radiation effects)
• Infertility, Female (epidemiology, etiology)
• Neoplasms (epidemiology, pathology, radiotherapy, rehabilitation)
• Pituitary Gland (pathology, radiation effects)
• Pregnancy
• Radiation Injuries (epidemiology)
• Radiotherapy Dosage
• Retrospective Studies
• Survivors