TY - JOUR
T1 - Pre-treatment fertility preservation and post-treatment reproduction in long-term survivors of adolescent and young adult (AYA) cancer
AU - Lehmann, Vicky
AU - Vlooswijk, Carla
AU - van der Graaf, Winette T. A.
AU - Bijlsma, Rhode
AU - Kaal, Suzanne E. J.
AU - Kerst, Jan Martijn
AU - Tromp, Jacqueline M.
AU - Bos, Monique E. M. M.
AU - van der Hulle, Tom
AU - Lalisang, Roy I.
AU - Nuver, Janine
AU - Kouwenhoven, Mathilde C. M.
AU - Lok, Christianne A. R.
AU - Beerendonk, Catharina C. M.
AU - Dinkelman-Smit, Marij
AU - Husson, Olga
PY - 2025/8
Y1 - 2025/8
N2 - PurposeTo describe recall of fertility-related consultations and cryopreservation and to examine reproductive goals and reproduction post-treatment in long-term survivors of adolescent and young adult (AYA) (age, 18-39 years) cancer.MethodsThis study included n = 1457 male and n = 2112 female long-term survivors (Mage = 43-45 years; 5-22 years from diagnosis) who provided self-report. Clinical data were supplied by the Netherlands Cancer Registry.ResultsMost male survivors (72.7%) recalled fertility-related consultations and 22.6% completed sperm cryopreservation. Younger age (OR = 2.8; 95%CI [2.2-3.6]), not having children (OR = 5.0; 95%CI [3.2-7.7]), testicular cancer or lymphoma/leukemia (OR = 2.8/2.5 relative to "others"), and more intense treatments (OR = 1.5; 95%CI [1.1-2.0]) were associated with higher cryopreservation rates. Time since diagnosis had no effect. Of men who cryopreserved, 12.1% utilized assisted reproductive technologies (ART). Most men (88.5%) felt their diagnosis did not affect their reproductive goals, but 7.6% wanted no (additional) children due to cancer. Half of female survivors (55.4%; n = 1171) recalled fertility-related consultations. Rates of cryopreservation were very low (3.6%), but increased after 2013 when oocyte cryopreservation became non-experimental. Of women who cryopreserved, 13.2% successfully utilized ART. Most women (74.8%) experienced no effects of cancer on reproductive goals, but 17.8% wanted no (additional) children due to cancer.ConclusionsCryopreservation in men varied by patient/clinical factors and was very low in women, but data of more recently treated females are needed. Utilizing cryopreserved material through ART was rare, which questions its cost-effectiveness, but it may enhance survivors' well-being.Implications for Cancer SurvivorsThe extent to which cryopreservation positively affects survivors' well-being remains to be tested. Moreover, effects of cancer on reproductive goals require further attention, especially in women who refrain from having children due to cancer.
AB - PurposeTo describe recall of fertility-related consultations and cryopreservation and to examine reproductive goals and reproduction post-treatment in long-term survivors of adolescent and young adult (AYA) (age, 18-39 years) cancer.MethodsThis study included n = 1457 male and n = 2112 female long-term survivors (Mage = 43-45 years; 5-22 years from diagnosis) who provided self-report. Clinical data were supplied by the Netherlands Cancer Registry.ResultsMost male survivors (72.7%) recalled fertility-related consultations and 22.6% completed sperm cryopreservation. Younger age (OR = 2.8; 95%CI [2.2-3.6]), not having children (OR = 5.0; 95%CI [3.2-7.7]), testicular cancer or lymphoma/leukemia (OR = 2.8/2.5 relative to "others"), and more intense treatments (OR = 1.5; 95%CI [1.1-2.0]) were associated with higher cryopreservation rates. Time since diagnosis had no effect. Of men who cryopreserved, 12.1% utilized assisted reproductive technologies (ART). Most men (88.5%) felt their diagnosis did not affect their reproductive goals, but 7.6% wanted no (additional) children due to cancer. Half of female survivors (55.4%; n = 1171) recalled fertility-related consultations. Rates of cryopreservation were very low (3.6%), but increased after 2013 when oocyte cryopreservation became non-experimental. Of women who cryopreserved, 13.2% successfully utilized ART. Most women (74.8%) experienced no effects of cancer on reproductive goals, but 17.8% wanted no (additional) children due to cancer.ConclusionsCryopreservation in men varied by patient/clinical factors and was very low in women, but data of more recently treated females are needed. Utilizing cryopreserved material through ART was rare, which questions its cost-effectiveness, but it may enhance survivors' well-being.Implications for Cancer SurvivorsThe extent to which cryopreservation positively affects survivors' well-being remains to be tested. Moreover, effects of cancer on reproductive goals require further attention, especially in women who refrain from having children due to cancer.
KW - Adolescence and young adulthood (AYA)
KW - Reproductive goals
KW - Fertility preservation
KW - Assisted reproductive technologies (ART)
KW - Oncology
KW - SPERM BANKING
KW - WOMEN
KW - INFORMATION
KW - OUTCOMES
KW - COMMUNICATION
KW - PREFERENCES
KW - EXPERIENCES
KW - INFERTILITY
KW - CHILDHOOD
KW - PROVISION
U2 - 10.1007/s11764-024-01538-x
DO - 10.1007/s11764-024-01538-x
M3 - Article
SN - 1932-2259
VL - 19
SP - 1143
EP - 1154
JO - Journal of Cancer Survivorship-Research and Practice
JF - Journal of Cancer Survivorship-Research and Practice
IS - 4
ER -