Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Cancer Tx and Infertility Risk in Women with PCOS

Fertil Steril; ePub 2018 Feb 7; Shandley, et al

Cancer survivors with polycystic ovary syndrome (PCOS) are less likely to meet reproductive goals compared with survivors without PCOS, a recent study found. The population-based cohort included 1,090 female cancer survivors aged 22 to 45 years, diagnosed between ages 20 and 35 years, and at least 2 years after diagnosis. 369 participated in a clinic visit; 374 reproductive-aged women without cancer also completed a clinic visit. Main outcome was infertility, time to first pregnancy after cancer diagnosis, and measures of ovarian reserve (antimüllerian hormone [AMH] and antral follicle count [AFC]). Researchers found:

  • 78 (7.2%) cancer survivors reported a PCOS diagnosis; 41 received gonadotoxic treatment.
  • Survivors with PCOS exposed to gonadotoxic treatment and unexposed were more likely to report infertility than unexposed survivors without PCOS and were likely to have fewer children than desired.
  • After adjusting for age, comparison women with PCOS had the highest markers of ovarian reserve and cancer survivors without PCOS treated with gonadotoxic agents had the lowest levels.

Citation:

Shandley LM, Fothergill A, Spencer JB, et al. Impact of cancer treatment on risk of infertility and diminished ovarian reserve in women with polycystic ovary syndrome. [Published online ahead of print February 7, 2018]. Fertil Steril. doi:10.1016/j.fertnstert.2017.11.016.

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