Abstract
Several concerns exist regarding the impact of anticancer treatments on fertility and pregnancy outcome. The detrimental effects of both chemotherapy and radiotherapy on the ovaries are well reported in the available literature. Fewer data are focused on the importance of a functioning uterus to conceive and carry on a healthy pregnancy. The aim of this paper is to provide a narrative review of the current literature to assess the role of uterine irradiation as a potential determinant of infertility and poor obstetrical outcomes. This review addresses the need for multidisciplinary counselling in order to face the poor reproductive and obstetrical outcomes of women who had uterine radiation, according to the different backgrounds (radiotherapy during adulthood versus childhood; total body irradiation versus pituitary, spinal and/or abdominal-pelvic irradiation).
Highlights
Nowadays, cancer survival continues to increase across high-income countries, even if international disparities persist [1]
Several concerns exist regarding the impact of cancer therapy on the pregnancy outcome [2]
Anderson et al [3] reported a standardised incidence ratio of 0.62, indicating that the number of pregnancies in a large cohort of cancer survivors is much lower than expected in the general population [3]
Summary
Cancer survival continues to increase across high-income countries, even if international disparities persist [1]. Several concerns exist regarding the impact of cancer therapy on the pregnancy outcome [2]. Anderson et al [3] reported a standardised incidence ratio of 0.62, indicating that the number of pregnancies in a large cohort of cancer survivors is much lower than expected in the general population [3]. This data could be explained by a loss of the reproductive function potentially induced by the need of chemotherapy, radiotherapy (RT) or a combination of both [4]
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