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

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Abstract

Purpose

Fertility 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.

Methods

Electronic databases were searched to identify studies that reported on reproductive outcomes after treatment for a gynecological malignancy.

Results

In 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 30.5 years and 30.3 years, 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 Survivors

Patients 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.

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Authors and Affiliations

  1. Department of Biostatistics, The Kirby Institute, University of New South Wales, Sydney, NSW, Australia

    Brigitte Gerstl & Handan Wand

  2. Kids Cancer Centre, Sydney Children’s Hospital, Sydney, NSW, 2031, Australia

    Brigitte Gerstl, Marcus Vallejo & Antoinette Anazodo

  3. Australian Centre for Public Health and Population Health Research, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia

    Elizabeth Sullivan

  4. Department of Epidemiology, Technical University of Munich, Munich, Germany

    Jana Koch

  5. Brighton and Sussex Medical School, Royal Sussex County Hospital, Brighton, UK

    Maximilian Johnson

  6. Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW, Australia

    Kate Webber & Antoinette Anazodo

  7. Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia

    Kate Webber

  8. Cancer and Palliative Care Research and Evaluation Unit, University of Western Australia, Crawley, WA, Australia

    Angela Ives

  9. School of Women’s and Children’s Health, Discipline of Paediatrics, University of New South Wales, Sydney, NSW, Australia

    Antoinette Anazodo

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  1. Brigitte Gerstl
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This article does not contain any studies with human participants or animals performed by any of the authors. The current study was a systematic review of existing studies that did not involve collection of new data.

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Gerstl, B., Sullivan, E., Vallejo, M. et al. Reproductive outcomes following treatment for a gynecological cancer diagnosis: a systematic review. J Cancer Surviv 13, 269–281 (2019). https://doi.org/10.1007/s11764-019-00749-x

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