Critical appraisal:Dillon KE, Sammel MD, Ginsberg JP, Lechtenberg L, Prewitt M, Gracia CR 2013 2

Critical Appraisal

Article being appraised

Dillon KE, Sammel MD, Ginsberg JP, Lechtenberg L, Prewitt M, Gracia CR. Pregnancy after cancer: results from a prospective cohort study of cancer survivors. Pediatr Blood Cancer 2013 Dec;60(12):2001-6 Available from: http://www.ncbi.nlm.nih.gov/pubmed/24038829.

Applicable clinical question

Are cancer survivors who received cancer treatment less likely than the general population to conceive or give birth after treatment?

Key Facts

Study Design

cohort study

Number of Patients:

200

Results of outcome(s):

Eighty-four female survivors (average age 26, and 14 years post-treatment) and 98 similar-aged controls that were sexually active with men were included. At baseline, 27/84 survivors and 42/98 controls reported a prior pregnancy. Adjusted models showed that anti-mullerian hormone (AMH) and antral follicle count (AFC) were impaired in survivors with a prior pregnancy compared to controls with a prior pregnancy (p<0.01, p=0.03). During follow-up in 56 survivors and 74 controls, 19 pregnancies occurred in survivors and 18 in controls. Comparison of MOR between survivors who became pregnant and controls who became pregnant revealed that AMH and AFC were impaired in survivors (p<0.05). Compared to survivors who did not become pregnant, survivors who did were older (p<0.01) and more likely to be cohabitating (p<0.01), but had similar MOR and exposure to alkylators (p=0.34).
Conclusions—Survivors achieved pregnancy at a rate similar to controls despite impaired MOR.

Includes an economic evaluation

no