ART Success and Long-Term Outcomes on Offspring of Cancer Survivors
Recent epidemiological studies indicate that worldwide there is a rise in the incidence of several cancers affecting subjects in their childhoods and young adulthoods. Simultaneously, with the advances in medical technology for early detection of cancer a
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ART Success and Long-Term Outcomes on Offspring of Cancer Survivors Peter T.K. Chan and Maria Belén Herrero
Introduction According to the latest statistics, the relative 5-year survival rate for all childhood cancers combined is approximately 84 and 87% among adolescent and young adult patients [1, 2]. It has been well documented in the literature that cancer and cancer therapies including surgeries, radiotherapy, and chemotherapy can compromise the fertility status of these survivors through various mechanisms ranging from alteration of body image and other psychosocial issues and sexual dysfunction to their negative impact on the quantity and quality of gametes [3–7]. In reality, many cancer survivors could maintain their fertility potential, depending on their baseline, pre-cancer fertility status, types and staging of cancers, nature and levels (e.g., dosage or intensity and duration of chemo- and radiotherapy) of treatment received, and their general mental and physical health statuses. Indeed, fertility is long recognized as one of the most important cancer survivorship issues, with over 75% of childless young cancer survivors stating their desire to have children and 80% viewing themselves very positively as potential parents [8]. It is also reported that fertility was consistently listed as one of the top three life goals among young cancer survivors [9]. Evidently young cancer survivors are concerned about their offspring’s health [10, 11]. In the following section we discuss the reproductive outcomes of cancer survivors’ offspring in three aspects, namely, the need of and access to assisted reproductive technologies, perinatal outcomes, and congenital anomalies. P.T.K. Chan, MD, CM, MSc, FRCS(C), FACS (*) Department of Surgery, McGill University, Montreal, QC, Canada Department of Urology, Research Institute of the McGill University Health Center, 1001 Boulevard Decarie, D5-5724, Montreal, QC, Canada, H4A 3J1 e-mail: [email protected] M.B. Herrero, PhD McGill University Health Center, Montreal, QC, Canada © Springer International Publishing AG 2018 A. Majzoub, A. Agarwal (eds.), The Complete Guide to Male Fertility Preservation, DOI 10.1007/978-3-319-42396-8_6
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P.T.K. Chan and M.B. Herrero
The Use of Assisted Reproductive Technologies Assisted reproductive technologies (ART’s), including intrauterine insemination (IUI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI), have helped many couples who failed to achieve natural pregnancy to become biological parents. In the past two decades, there has been a significant increase in the number of reproductive centers worldwide. Simultaneously, with the increase in the efficacy and our understanding on the safety of these technologies [12, 13], their acceptance by societies and access by infertile couples have increased tremendously in recent years. When experiencing infertility, both female and male cancer survivors with gonadal dysfunction post-cancer therapies may benefit from ARTs to use their fresh gametes for
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