Abstract
We have audited the invitation for uptake and outcome of artificial reproductive techniques in patients undergoing SCT for haematological malignancy, with the aim of improving our pre-transplant counselling. A postal survey was sent to 434 patients in our centre surviving a minimum of 2 years after allo-SCT, of whom 221 patients responded. Of 112 male patients, 79 were offered sperm storage, 42 banked sperm and 25 subsequently attempted parenthood with stored sperm. A total of 18 were successful, with 29 children born a median of 8 years (range 1–22 years) following SCT. Of 72 females <42 years old, 33 were offered storage of embryos/eggs/ovarian tissue and 12 accepted. Following SCT, four women attempted pregnancy using cryopreserved embryos, with two successes. The majority of patients who were not counselled about infertility or not offered fertility-preservation options provided a likely reason, with completion of family being the most frequent. Nonetheless, 16 patients (11/72 women and 5/112 men) could not provide a reason for the lack of information/invitation. In conclusion, uptake of gamete/embryo storage is high when offered and collected material is used frequently. Pregnancies in partners of male patients were usually successful and our data highlight the value of prolonged cryostorage.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Apperley JF (ed.). European School of Haematology. The EBMT Handbook Haematopoietic Stem Cell Transplantation. Paris, 2008.
Ethics Committee of the American Society for Reproductive Medicine. Fertility preservation and reproduction in cancer patients. Fertil Steril 2005; 83: 1622–1628.
Schimmer AD, Quatermain M, Imrie K, Ali V, McCrae J, Stewart AK et al. Ovarian function after autologous bone marrow transplantation. J Clin Oncol 1998; 16: 2359–2363.
Sanders JE, Hawley J, Levy W, Gooley T, Buckner CD, Deeg HJ et al. Pregnancies following high-dose cyclophosphamide with or without high-dose busulfan or total-body irradiation and bone marrow transplantation. Blood 1996; 87: 3045–3052.
Schover LR, Rybicki LA, Martin BA, Bringelsen KA . Having children after cancer. Cancer 1999; 86: 697–709.
Chatterjee R, Kottaridis PD . Treatment of gonadal damage in recipients of allogeneic or autologous transplantation for haematological malignancies. Bone Marrow Transplant 2002; 30: 629–635.
Maltaris T, Koelbl H, Seufert R, Kiesewetter F, Beckmann MW, Mueller A et al. Gonadal damage and options for fertility preservation in female and male cancer survivors. Asian J Androl 2006; 8: 515–533.
Health NCCfWsaCs. Fertility: assessment and treatment for people with fertility problems. Clinical Guideline, 11 In 2004.
Royal College of Physicians TRCoR, Royal, Gynaecologists. CoOa. The Effects of Cancer Treatment on Reproductive Functions: Guidance on Management. Report of a Working Party. RCP: London, 2007.
Letendre L, Moore SB . Successful pregnancy after conditioning with cyclophosphamide and fractionated total body irradiation. Med Pediatr Oncol 1997; 28: 147–148.
Schover LR, Brey K, Lichtin A, Lipshultz LI, Jeha S . Knowledge and experience regarding cancer, infertility, and sperm banking in younger male survivors. J Clin Oncol 2002; 20: 1880–1889.
Schover LR, Brey K, Lichtin A, Lipshultz LI, Jeha S . Oncologists' attitudes and practices regarding banking sperm before cancer treatment. J Clin Oncol 2002; 20: 1890–1897.
Gilbert E, Adams A, Mehanna H, Harrison B, Hartshorne GM . Who should be offered sperm banking for fertility preservation? A survey of UK oncologists and haematologists. Ann Oncol 2011; 22: 1209–1214.
Duffy CM, Allen SM, Clark MA . Discussions regarding reproductive health for young women with breast cancer undergoing chemotherapy. J Clin Oncol 2005; 23: 766–773.
Khalifa E, Oehninger S, Acosta AA, Morshedi M, Veeck L, Bryzyski RG et al. Successful fertilization and pregnancy outcome in in-vitro fertilization using cryopreserved/thawed spermatozoa from patients with malignant diseases. Hum Reprod 1992; 7: 105–108.
Hallak J, Hendin BN, Thomas Jr AJ, Agarwal A . Investigation of fertilizing capacity of cryopreserved spermatozoa from patients with cancer. J Urol 1998; 159: 1217–1220.
Audrins P, Holden CA, McLachlan RI, Kovacs GT . Semen storage for special purposes at Monash IVF from 1977 to 1997. Fertil Steril 1999; 72: 179–181.
Lass A, Akagbosu F, Brinsden P . Sperm banking and assisted reproduction treatment for couples following cancer treatment of the male partner. Hum Reprod Update 2001; 7: 370–377.
Agarwal A, Ranganathan P, Kattal N, Pasqualotto F, Hallak J, Khayal S et al. Fertility after cancer: a prospective review of assisted reproductive outcome with banked semen specimens. Fertil Steril 2004; 81: 342–348.
HFEA. Fertility problems and treatment—facts & figures. 2006–2007.
Salooja N, Szydlo RM, Socie G, Rio B, Chatterjee R, Ljungman P et al. Pregnancy outcomes after peripheral blood or bone marrow transplantation: a retrospective survey. Lancet 2001; 358: 271–276.
Urbano MT, Tait DM . Can the irradiated uterus sustain a pregnancy? A literature review. Clin Oncol (R Coll Radiol) 2004; 16: 24–28.
Acknowledgements
Administrative costs were supported by funding from the North West London Cancer Network. We are also grateful for support from the NIHR Biomedical Research Centre funding scheme.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Babb, A., Farah, N., Lyons, C. et al. Uptake and outcome of assisted reproductive techniques in long-term survivors of SCT. Bone Marrow Transplant 47, 568–573 (2012). https://doi.org/10.1038/bmt.2011.134
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/bmt.2011.134
Keywords
This article is cited by
-
Male-specific late effects in adult hematopoietic cell transplantation recipients: a systematic review from the Late Effects and Quality of Life Working Committee of the Center for International Blood and Marrow Transplant Research and Transplant Complications Working Party of the European Society of Blood and Marrow Transplantation
Bone Marrow Transplantation (2022)
-
Reproductive outcomes following a stem cell transplant for a haematological malignancy in female cancer survivors: a systematic review and meta-analysis
Supportive Care in Cancer (2019)
-
Counseling young women with early breast cancer on fertility preservation
Journal of Assisted Reproduction and Genetics (2019)
-
Delayed childbearing and female ageing impair assisted reproductive technology outcome in survivors of male haematological cancers
Journal of Assisted Reproduction and Genetics (2018)
-
Clinical guide to fertility preservation in hematopoietic cell transplant recipients
Bone Marrow Transplantation (2014)