Fertility preservation in women with haematological malignancies

Hum Fertil (Camb). 2023 Dec;26(5):998-1007. doi: 10.1080/14647273.2022.2042605. Epub 2022 Feb 21.

Abstract

The incidence of haematological malignancies is increasing in women of childbearing age. Survival rates accompany this increase, making it essential to assess the impact of treatments on their future quality of life, evaluate the impact of each treatment on ovarian reserve and define the fertility preservation techniques used by women with haematologic malignancies. A retrospective study was conducted after data collection from 61 women diagnosed with haematological malignancies and followed-up in a fertility preservation centre between January 2008 and June 2019. Cancer treatments caused a decrease in ovarian reserve, demonstrated by an increase in FSH levels and a decrease in AMH levels. When assessing which treatments have the greatest impact on AMH levels, we found that the BEACOPP regimen, and the agents vincristine, etoposide, procarbazine, prednisone and the haematopoietic stem cell transplantation were mainly responsible. Regarding pregnancy after oncological treatments, of the eleven women who became pregnant, ten did so spontaneously. This study reinforces the importance of referring patients to a fertility preservation consultation before starting oncological treatment, as most of them opt to preserve fertility. This work also helps to clarify the impact of each chemotherapeutic agent on the ovarian reserve.

Keywords: Fertility preservation; haematological malignancies; ovarian reserve; retrospective study; women of reproductive age.

MeSH terms

  • Etoposide
  • Female
  • Fertility
  • Fertility Preservation* / methods
  • Hematologic Neoplasms* / drug therapy
  • Humans
  • Ovarian Reserve*
  • Pregnancy
  • Quality of Life
  • Retrospective Studies

Substances

  • Etoposide