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.


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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USPSTF: Screening for Ovarian Cancer, JAMA; 2018 Feb 13; USPSTF, Grossman, et al