Use of fertility drugs in early onset female cancer survivors –A Finnish register-based study on 8,929 survivors

Johanna Melin, Laura Madanat-Harjuoja, Elli Hirvonen, Karri Seppä, Nea Malila, Janne Pitkäniemi, Mika Gissler, Aila Tiitinen

Tutkimustuotos: ArtikkelijulkaisuArtikkeliTieteellinenvertaisarvioitu

Kuvaus

Advances in multimodality cancer treatments have increased the risk of long-term complications in early onset cancer survivors. For female cancer survivors these include diminished reproductive function, often resulting in a narrowed fertile window. The aim of this study was to evaluate the use of fertility treatments in cancer survivors (aged 0-39 years at diagnosis) compared to siblings. Data from Finnish registers on cancer, birth and prescribed medications were merged to identify 8,929 survivors and 9,495 siblings without previous deliveries. Fertility drug purchases from 1993 to 2012 at the age of 16-41 years were included. A Poisson regression model was used to estimate incidence rate ratios (IRR) for the use of fertility drugs, adjusting for age and calendar time at fertility drug purchase. Fertility treatments were more common in survivors compared to siblings, as 6.1% of survivors compared to 3.8% of siblings had bought fertility drugs (IRR 1.43, 95% confidence interval [CI] 1.25-1.65). A sub-classification of fertility treatments into ovulation inductions and assisted reproductive technology (ART), showed increased use of ART (IRR 2.41, 95 % CI 1.97-2.96), whereas the use of ovulation induction was similar in survivors and siblings. Analyses by calendar time periods showed the use of ART to be significantly higher in the most recent decade, from 2003 onwards. We conclude that cancer survivors have an increased risk for subfertility, which is why fertility counselling is important. However, our results mirror a more active approach among clinicians towards fertility treatments in cancer survivors during the most recent years. This article is protected by copyright. All rights reserved.
Alkuperäiskielienglanti
LehtiInternational Journal of Cancer
Numeroj
ISSN0020-7136
DOI - pysyväislinkit
TilaJulkaistu - 16 huhtikuuta 2019
OKM-julkaisutyyppiA1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä, vertaisarvioitu

Tieteenalat

  • 3122 Syöpätaudit

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title = "Use of fertility drugs in early onset female cancer survivors –A Finnish register-based study on 8,929 survivors",
abstract = "Advances in multimodality cancer treatments have increased the risk of long-term complications in early onset cancer survivors. For female cancer survivors these include diminished reproductive function, often resulting in a narrowed fertile window. The aim of this study was to evaluate the use of fertility treatments in cancer survivors (aged 0-39 years at diagnosis) compared to siblings. Data from Finnish registers on cancer, birth and prescribed medications were merged to identify 8,929 survivors and 9,495 siblings without previous deliveries. Fertility drug purchases from 1993 to 2012 at the age of 16-41 years were included. A Poisson regression model was used to estimate incidence rate ratios (IRR) for the use of fertility drugs, adjusting for age and calendar time at fertility drug purchase. Fertility treatments were more common in survivors compared to siblings, as 6.1{\%} of survivors compared to 3.8{\%} of siblings had bought fertility drugs (IRR 1.43, 95{\%} confidence interval [CI] 1.25-1.65). A sub-classification of fertility treatments into ovulation inductions and assisted reproductive technology (ART), showed increased use of ART (IRR 2.41, 95 {\%} CI 1.97-2.96), whereas the use of ovulation induction was similar in survivors and siblings. Analyses by calendar time periods showed the use of ART to be significantly higher in the most recent decade, from 2003 onwards. We conclude that cancer survivors have an increased risk for subfertility, which is why fertility counselling is important. However, our results mirror a more active approach among clinicians towards fertility treatments in cancer survivors during the most recent years. This article is protected by copyright. All rights reserved.",
keywords = "Female cancer survivors, infertility, fertility treatments, ART, 3122 Cancers",
author = "Johanna Melin and Laura Madanat-Harjuoja and Elli Hirvonen and Karri Sepp{\"a} and Nea Malila and Janne Pitk{\"a}niemi and Mika Gissler and Aila Tiitinen",
year = "2019",
month = "4",
day = "16",
doi = "10.1002/ijc.32346",
language = "English",
journal = "International Journal of Cancer",
issn = "0020-7136",
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Use of fertility drugs in early onset female cancer survivors –A Finnish register-based study on 8,929 survivors. / Melin, Johanna; Madanat-Harjuoja, Laura; Hirvonen, Elli; Seppä, Karri; Malila, Nea; Pitkäniemi, Janne; Gissler, Mika; Tiitinen, Aila.

julkaisussa: International Journal of Cancer, Nro j, 16.04.2019.

Tutkimustuotos: ArtikkelijulkaisuArtikkeliTieteellinenvertaisarvioitu

TY - JOUR

T1 - Use of fertility drugs in early onset female cancer survivors –A Finnish register-based study on 8,929 survivors

AU - Melin, Johanna

AU - Madanat-Harjuoja, Laura

AU - Hirvonen, Elli

AU - Seppä, Karri

AU - Malila, Nea

AU - Pitkäniemi, Janne

AU - Gissler, Mika

AU - Tiitinen, Aila

PY - 2019/4/16

Y1 - 2019/4/16

N2 - Advances in multimodality cancer treatments have increased the risk of long-term complications in early onset cancer survivors. For female cancer survivors these include diminished reproductive function, often resulting in a narrowed fertile window. The aim of this study was to evaluate the use of fertility treatments in cancer survivors (aged 0-39 years at diagnosis) compared to siblings. Data from Finnish registers on cancer, birth and prescribed medications were merged to identify 8,929 survivors and 9,495 siblings without previous deliveries. Fertility drug purchases from 1993 to 2012 at the age of 16-41 years were included. A Poisson regression model was used to estimate incidence rate ratios (IRR) for the use of fertility drugs, adjusting for age and calendar time at fertility drug purchase. Fertility treatments were more common in survivors compared to siblings, as 6.1% of survivors compared to 3.8% of siblings had bought fertility drugs (IRR 1.43, 95% confidence interval [CI] 1.25-1.65). A sub-classification of fertility treatments into ovulation inductions and assisted reproductive technology (ART), showed increased use of ART (IRR 2.41, 95 % CI 1.97-2.96), whereas the use of ovulation induction was similar in survivors and siblings. Analyses by calendar time periods showed the use of ART to be significantly higher in the most recent decade, from 2003 onwards. We conclude that cancer survivors have an increased risk for subfertility, which is why fertility counselling is important. However, our results mirror a more active approach among clinicians towards fertility treatments in cancer survivors during the most recent years. This article is protected by copyright. All rights reserved.

AB - Advances in multimodality cancer treatments have increased the risk of long-term complications in early onset cancer survivors. For female cancer survivors these include diminished reproductive function, often resulting in a narrowed fertile window. The aim of this study was to evaluate the use of fertility treatments in cancer survivors (aged 0-39 years at diagnosis) compared to siblings. Data from Finnish registers on cancer, birth and prescribed medications were merged to identify 8,929 survivors and 9,495 siblings without previous deliveries. Fertility drug purchases from 1993 to 2012 at the age of 16-41 years were included. A Poisson regression model was used to estimate incidence rate ratios (IRR) for the use of fertility drugs, adjusting for age and calendar time at fertility drug purchase. Fertility treatments were more common in survivors compared to siblings, as 6.1% of survivors compared to 3.8% of siblings had bought fertility drugs (IRR 1.43, 95% confidence interval [CI] 1.25-1.65). A sub-classification of fertility treatments into ovulation inductions and assisted reproductive technology (ART), showed increased use of ART (IRR 2.41, 95 % CI 1.97-2.96), whereas the use of ovulation induction was similar in survivors and siblings. Analyses by calendar time periods showed the use of ART to be significantly higher in the most recent decade, from 2003 onwards. We conclude that cancer survivors have an increased risk for subfertility, which is why fertility counselling is important. However, our results mirror a more active approach among clinicians towards fertility treatments in cancer survivors during the most recent years. This article is protected by copyright. All rights reserved.

KW - Female cancer survivors

KW - infertility

KW - fertility treatments

KW - ART

KW - 3122 Cancers

U2 - 10.1002/ijc.32346

DO - 10.1002/ijc.32346

M3 - Article

JO - International Journal of Cancer

JF - International Journal of Cancer

SN - 0020-7136

IS - j

ER -