ART Success and Long-Term Outcomes on Offspring of Cancer Survivors

Abstract

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 and the improvement in the efficacy of cancer therapies, the survival rates of many of these young cancer patients have improved dramatically in the past decades. Many young cancer survivors have not started or completed forming a family. Thus, the impact of cancer and cancer therapies on their reproductive health and the options for fertility preservation are important issues in the survivorship for young cancer patients. In this chapter, we first provide an overview of the epidemiology of cancer survival in the young population of reproductive age with a focus on the importance of different fertility issues in cancer survivorship. The role, access, and outcomes of assisted reproduction among young cancer survivors are reviewed. Finally, we present some of the registry studies in the latest literature and raise some controversies on the notion of the general health of offspring of cancer survivors. It is our hope that investigators in the field will continue to synthesize new data to bridge the new knowledge gaps identified not only to settle some of the controversies on the subject of fertility after cancer but, most importantly, to allow also proper counseling strategies to be developed to inform young cancer survivors their fertility prospects after cancer with a focus on the long-term biopsychosocial well-being of their offspring.