Women who undergo allogeneic hematopoietic cell transplantation (alloHCT) face significant treatment-related challenges regarding fertility. However, science seems to be overcoming many treatment-related fertility challenges after alloHCT and successful pregnancies are possible according to results from a German study.
According to an article in MedPage Today, of 2,654 women who underwent alloHCT from 2003 to 2018 referenced in the German Transplant Registry, 50 experienced 74 pregnancies, with 57 pregnancies resulting in live births (77%). The data was reported by Katja Sockel, MD, and colleagues of the University Hospital Carl Gustav Carus in Dresden, and colleagues.
Of note, according to German population data, the live birth rate for women in 2019 was 6.43%, with a first live birth rate of 3.02%.
“Although the annual first birth rate after alloHCT is more than six times lower than in the general German population, the findings suggest ‘a realistic chance for pregnancy,'” Dr. Sockel and colleagues wrote in an email to MedPage Today. Dr. Sockel noted that “the results of this study show that female alloHCT recipients can achieve safe pregnancies. These findings help provide a basis for counseling young women of childbearing age and raising awareness of and funding for different ART [assisted reproductive technologies] techniques so that patients can have a normal life after alloHCT.”
Dr. Sockel also stressed that all cancer patients of childbearing age as well as patients with non-malignant diseases facing intensive therapies such as alloHCT, should receive fertility counseling. “Ideally, fertility counseling should be implemented as early as possible,” she said, emphasizing that counseling and recommendations on different fertility-preserving interventions should be individualized and consider factors such as disease stage, hormone status and the underlying disease.
In the case of women who either underwent alloHCT or have breast cancer, Dr. Sockel pointed out that the intensity of the conditioning regimen used in alloHCT will likely result in a higher risk of permanent infertility.
“Moreover, patients who undergo alloHCT due to an underlying malignant disease have often been exposed to various toxic chemotherapies before the transplant,” she said. “Additionally, young patients typically receive intensive conditioning protocols, including total body irradiation, further elevating the risk of infertility in these patients.”
The likelihood of pregnancy in transplanted women was positively correlated with younger age with most pregnancies occurring in women ages 18 to 25. No pregnancies were reported in women who underwent transplantation over 35 years of age.
You can learn more about the findings of the alloHCT study over at MedPage Today.
