Male infertility in long-term survivors of pediatric cancer

A report from the childhood cancer survivor study

K. Wasilewski-Masker, K. D. Seidel, W. Leisenring, A. C. Mertens, M. Shnorhavorian, C. W. Ritenour, M. Stovall, D. M. Green, C. A. Sklar, Gregory Armstrong, L. L. Robison, L. R. Meacham

Research output: Contribution to journalArticle

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Abstract

Purpose: The purpose of this study was to assess the prevalence of male infertility and treatment-related risk factors in childhood cancer survivors. Methods: Within the Childhood Cancer Survivor Study, 1,622 survivors and 274 siblings completed the Male Health Questionnaire. The analysis was restricted to survivors (938/1,622; 57.8 %) and siblings (174/274; 63.5 %) who tried to become pregnant. Relative risks (RR) and 95 % confidence intervals (CI) for the prevalence of self-reported infertility were calculated using generalized linear models for demographic variables and treatment-related factors to account for correlation among survivors and siblings of the same family. All statistical tests were two-sided. Results: Among those who provided self-report data, the prevalence of infertility was 46.0 % in survivors versus 17.5 % in siblings (RR = 2.64, 95 % CI 1.88-3.70, p < 0.001). Of survivors who met the definition for infertility, 37 % had reported at least one pregnancy with a female partner that resulted in a live birth. In a multivariable analysis, risk factors for infertility included an alkylating agent dose (AAD) score ≥3 (RR = 2.13, 95 % CI 1.69-2.68 for AAD ≥3 versus AAD <3), surgical excision of any organ of the genital tract (RR = 1.63, 95 % CI 1.20-2.21), testicular radiation ≥4 Gy (RR = 1.99, 95 % CI 1.52-2.61), and exposure to bleomycin (RR = 1.55, 95 % CI 1.20-2.01). Conclusion: Many survivors who experience infertility father their own children, suggesting episodes of both fertility and infertility. This and the novel association of infertility with bleomycin warrant further investigation. Implications for Cancer Survivors: Though infertility is common, male survivors reporting infertility often father their own children. Bleomycin may pose some fertility risk.

Original languageEnglish (US)
Pages (from-to)437-447
Number of pages11
JournalJournal of Cancer Survivorship
Volume8
Issue number3
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Male Infertility
Survivors
Infertility
Pediatrics
Confidence Intervals
Neoplasms
Siblings
Alkylating Agents
Bleomycin
Fathers
Fertility
Radiation Dosage
Genitalia
Live Birth
Self Report
Linear Models
Demography
Pregnancy

All Science Journal Classification (ASJC) codes

  • Oncology
  • Oncology(nursing)

Cite this

Wasilewski-Masker, K., Seidel, K. D., Leisenring, W., Mertens, A. C., Shnorhavorian, M., Ritenour, C. W., ... Meacham, L. R. (2014). Male infertility in long-term survivors of pediatric cancer: A report from the childhood cancer survivor study. Journal of Cancer Survivorship, 8(3), 437-447. https://doi.org/10.1007/s11764-014-0354-6

Male infertility in long-term survivors of pediatric cancer : A report from the childhood cancer survivor study. / Wasilewski-Masker, K.; Seidel, K. D.; Leisenring, W.; Mertens, A. C.; Shnorhavorian, M.; Ritenour, C. W.; Stovall, M.; Green, D. M.; Sklar, C. A.; Armstrong, Gregory; Robison, L. L.; Meacham, L. R.

In: Journal of Cancer Survivorship, Vol. 8, No. 3, 01.01.2014, p. 437-447.

Research output: Contribution to journalArticle

Wasilewski-Masker, K, Seidel, KD, Leisenring, W, Mertens, AC, Shnorhavorian, M, Ritenour, CW, Stovall, M, Green, DM, Sklar, CA, Armstrong, G, Robison, LL & Meacham, LR 2014, 'Male infertility in long-term survivors of pediatric cancer: A report from the childhood cancer survivor study', Journal of Cancer Survivorship, vol. 8, no. 3, pp. 437-447. https://doi.org/10.1007/s11764-014-0354-6
Wasilewski-Masker K, Seidel KD, Leisenring W, Mertens AC, Shnorhavorian M, Ritenour CW et al. Male infertility in long-term survivors of pediatric cancer: A report from the childhood cancer survivor study. Journal of Cancer Survivorship. 2014 Jan 1;8(3):437-447. https://doi.org/10.1007/s11764-014-0354-6
Wasilewski-Masker, K. ; Seidel, K. D. ; Leisenring, W. ; Mertens, A. C. ; Shnorhavorian, M. ; Ritenour, C. W. ; Stovall, M. ; Green, D. M. ; Sklar, C. A. ; Armstrong, Gregory ; Robison, L. L. ; Meacham, L. R. / Male infertility in long-term survivors of pediatric cancer : A report from the childhood cancer survivor study. In: Journal of Cancer Survivorship. 2014 ; Vol. 8, No. 3. pp. 437-447.
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abstract = "Purpose: The purpose of this study was to assess the prevalence of male infertility and treatment-related risk factors in childhood cancer survivors. Methods: Within the Childhood Cancer Survivor Study, 1,622 survivors and 274 siblings completed the Male Health Questionnaire. The analysis was restricted to survivors (938/1,622; 57.8 {\%}) and siblings (174/274; 63.5 {\%}) who tried to become pregnant. Relative risks (RR) and 95 {\%} confidence intervals (CI) for the prevalence of self-reported infertility were calculated using generalized linear models for demographic variables and treatment-related factors to account for correlation among survivors and siblings of the same family. All statistical tests were two-sided. Results: Among those who provided self-report data, the prevalence of infertility was 46.0 {\%} in survivors versus 17.5 {\%} in siblings (RR = 2.64, 95 {\%} CI 1.88-3.70, p < 0.001). Of survivors who met the definition for infertility, 37 {\%} had reported at least one pregnancy with a female partner that resulted in a live birth. In a multivariable analysis, risk factors for infertility included an alkylating agent dose (AAD) score ≥3 (RR = 2.13, 95 {\%} CI 1.69-2.68 for AAD ≥3 versus AAD <3), surgical excision of any organ of the genital tract (RR = 1.63, 95 {\%} CI 1.20-2.21), testicular radiation ≥4 Gy (RR = 1.99, 95 {\%} CI 1.52-2.61), and exposure to bleomycin (RR = 1.55, 95 {\%} CI 1.20-2.01). Conclusion: Many survivors who experience infertility father their own children, suggesting episodes of both fertility and infertility. This and the novel association of infertility with bleomycin warrant further investigation. Implications for Cancer Survivors: Though infertility is common, male survivors reporting infertility often father their own children. Bleomycin may pose some fertility risk.",
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