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The Impact of Uterine Radiation on Subsequent Fertility and Pregnancy Outcomes

Future fertility is of paramount importance to younger cancer survivors. Advances in assisted reproductive technology mean that young women treated with radiation involving the uterus may require clinical guidance regarding whether to attempt a pregnancy themselves. We performed a review of the lite...

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Autores principales: Teh, Wan Tinn, Stern, Catharyn, Chander, Sarat, Hickey, Martha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140124/
https://www.ncbi.nlm.nih.gov/pubmed/25165706
http://dx.doi.org/10.1155/2014/482968
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author Teh, Wan Tinn
Stern, Catharyn
Chander, Sarat
Hickey, Martha
author_facet Teh, Wan Tinn
Stern, Catharyn
Chander, Sarat
Hickey, Martha
author_sort Teh, Wan Tinn
collection PubMed
description Future fertility is of paramount importance to younger cancer survivors. Advances in assisted reproductive technology mean that young women treated with radiation involving the uterus may require clinical guidance regarding whether to attempt a pregnancy themselves. We performed a review of the literature regarding radiation involving uterus (total body irradiation (TBI) and pelvic radiation), fertility, and pregnancy outcomes to come up with a recommendation for our patients. Limited evidence suggests lower fecundity and an increased incidence of pregnancy complications after uterine radiation. Higher radiation doses and direct uterine radiation both significantly increase the risk of an adverse pregnancy outcome. Uterine radiation doses of <4 Gy do not appear to impair uterine function. Adult TBI data (usually 12 Gy) suggest pregnancy is possible but with lower fecundity and more complications. Although there is no clear data indicating the dose of radiation to the uterus, above which a pregnancy would not be sustainable, we suggest patients receiving >45 Gy during adulthood and >25 Gy in childhood be counselled to avoid attempting pregnancy. There is preliminary evidence that menopausal hormone therapy and a combination of pentoxifylline and tocopherol may improve uterine function following irradiation.
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spelling pubmed-41401242014-08-27 The Impact of Uterine Radiation on Subsequent Fertility and Pregnancy Outcomes Teh, Wan Tinn Stern, Catharyn Chander, Sarat Hickey, Martha Biomed Res Int Review Article Future fertility is of paramount importance to younger cancer survivors. Advances in assisted reproductive technology mean that young women treated with radiation involving the uterus may require clinical guidance regarding whether to attempt a pregnancy themselves. We performed a review of the literature regarding radiation involving uterus (total body irradiation (TBI) and pelvic radiation), fertility, and pregnancy outcomes to come up with a recommendation for our patients. Limited evidence suggests lower fecundity and an increased incidence of pregnancy complications after uterine radiation. Higher radiation doses and direct uterine radiation both significantly increase the risk of an adverse pregnancy outcome. Uterine radiation doses of <4 Gy do not appear to impair uterine function. Adult TBI data (usually 12 Gy) suggest pregnancy is possible but with lower fecundity and more complications. Although there is no clear data indicating the dose of radiation to the uterus, above which a pregnancy would not be sustainable, we suggest patients receiving >45 Gy during adulthood and >25 Gy in childhood be counselled to avoid attempting pregnancy. There is preliminary evidence that menopausal hormone therapy and a combination of pentoxifylline and tocopherol may improve uterine function following irradiation. Hindawi Publishing Corporation 2014 2014-08-06 /pmc/articles/PMC4140124/ /pubmed/25165706 http://dx.doi.org/10.1155/2014/482968 Text en Copyright © 2014 Wan Tinn Teh et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Teh, Wan Tinn
Stern, Catharyn
Chander, Sarat
Hickey, Martha
The Impact of Uterine Radiation on Subsequent Fertility and Pregnancy Outcomes
title The Impact of Uterine Radiation on Subsequent Fertility and Pregnancy Outcomes
title_full The Impact of Uterine Radiation on Subsequent Fertility and Pregnancy Outcomes
title_fullStr The Impact of Uterine Radiation on Subsequent Fertility and Pregnancy Outcomes
title_full_unstemmed The Impact of Uterine Radiation on Subsequent Fertility and Pregnancy Outcomes
title_short The Impact of Uterine Radiation on Subsequent Fertility and Pregnancy Outcomes
title_sort impact of uterine radiation on subsequent fertility and pregnancy outcomes
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4140124/
https://www.ncbi.nlm.nih.gov/pubmed/25165706
http://dx.doi.org/10.1155/2014/482968
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