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FeCt, national questionnaire survey 2008
Following the Berlin questionnaire survey in 2006, we conducted a nationwide survey on the topic of "Fertility after chemotherapy and radiotherapy in children and adolescents, FeCt" in 2008–2009. The fertility data were then correlated with details on the underlying disease and individual treatment, in order to allow identification of drugs, dosages, and radiotherapy treatments that may impair fertility in pediatric oncology.
A total of 4689 former patients from all over Germany who were adults at the time of the survey received the questionnaire from the German Pediatric Cancer Registry. Of those contacted, 61% agreed to take part (n = 2754; 1461 women, 1293 men). Their average age was 25. Among the participants, 41% stated that they had been given information regarding the risk of infertility. Ninety percent of the participants stated that they wished to have children. Reasons for not having children of their own, yet, included "Fear that the child might also develop cancer" (6%) and "Fear of the disease breaking out again" http://www.kinderkrebsstiftung.de/fileadmin/Redaktion/Zeitschrift_Wir/2010_4/FruchtbarkeitNachKrebstherapie.pdf(2%). You can find links to our article on this topics:
A total of 112 of 1061 female participants (11%) stated that they had had transient amenorrhea (cessation of periods) following chemotherapy and/or radiotherapy. Thirty-eight of the 1061 female participants stated that they had permanent amenorrhea (4%). Of the 2722 female participants or partners of male participants, 470 (17%) had already been pregnant. The miscarriage rate was 13% and the abortion rate was 7%. A total of 619 children had been born, 72 of whom were premature.
Among the male participants, 118 had undergone a fertility examination. Infertility was diagnosed in 25% of these participants. Among the 83 female participants who had already undergone a fertility examination, 31% reported results suggesting infertility. You can find an article for patients about this topic here and for proffessionals here. An article on the topic "Age at menarche after Chemottherapy or radiation" you can read here.
Significant risk factors for impaired fertility were postpubertal age at the start of treatment, as well as pelvic irradiation.
The percentage wishing to have children among former patients corresponded to that in the general population of the same age. The number of pregnancies was significantly reduced in comparison with the general population of the same age. The rate of terminated pregnancies among the survivors was significantly lower than in the general population of the same age.
You can find a link to our article on this topic here.
The rate of malformations, the average birth weight, and the head circumference were similar to those in the general population, and the number of premature births was slightly higher.
We consider that providing patients with comprehensive information regarding the risk of infertility is necessary so that prophylactic measures can be taken when appropriate. You can find a link to our article on patient counselling on the risk of infertility and its impact on childhood cancer survivors here.
Having leukemia in childhood and adolescence impairs the likelihood of becoming a parent but reduced neither the wish to have children nor the level of graduation. An article on the topic "Level of graduation" you can find here.