1. ¹Population Sciences, City of Hope Cancer Center, Duarte, CA, USA
2. ²Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN, USA
3. ³Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN, USA
4. ⁴General Pediatrics, University of Michigan, Ann Arbor, MI, USA
5. ⁵Hematology and Hematopoietic Cell Transplantation, City of Hope Cancer Center, Duarte, CA, USA

Correspondence: Dr S Bhatia, City of Hope Cancer Center, 1500 East Duarte Road, Duarte, CA 91010-3000, USA. E-mail: sbhatia@coh.org

Received 24 February 2006; Revised 8 March 2006; Accepted 9 March 2006; Published online 10 April 2006.

Abstract

We conducted a retrospective study to describe the magnitude of compromise in reproductive function and investigate pregnancy outcomes in 619 women and partners of men treated with autologous (n=241) or allogeneic (n=378) hematopoietic cell transplantation (HCT) between 21 and 45 years of age, and surviving 2 or more years. Median age at HCT was 33.3 years and median time since HCT 7.7 years. Mailed questionnaires captured pregnancies and their outcomes (live birth, stillbirth, miscarriage). Thirty-four patients reported 54 pregnancies after HCT (26 males, 40 pregnancies; eight females, 14 pregnancies), of which 46 resulted in live births. Factors associated with reporting no conception included older age at HCT (30 years: odds ratio (OR)=4.8), female sex (OR=3.0), and total body irradiation (OR=3.3). Prevalence of conception and pregnancy outcomes in HCT survivors were compared to those of 301 nearest-age siblings. Although the risk for not reporting a conception was significantly increased among HCT survivors (OR=36), survivors were not significantly more likely than siblings to report miscarriage or stillbirth (OR=0.7). Although prevalence of conception is diminished after HCT, if pregnancy does occur, outcome is likely to be favorable. Patients should be counseled prior to transplant regarding strategies to preserve fertility.