Endocrine Abstracts

JOINT3929

Introduction: Advances in cancer treatments have significantly improved the prognosis of pediatric cancers, with 5-year survival rates approaching 75-80%. However, fertility is affected in 8-12% of female survivors. Several studies suggest that cancer survivors have a similar likelihood of maintaining pregnancy beyond 20 weeks, but preterm birth rates are higher, with nearly 9% of babies born to mothers with cancer being premature (<37 weeks) compared to 6% in those without cancer treatment.

Objective: To evaluate the characteristics of pregnancies in patients undergoing oncological treatment in the childhood-juvenile stage.

Population and methods: Patients with a history of oncological disease in the childhood-juvenile stage treated at the Professor Alejandro Posadas National Hospital were studied, evaluated during the period from 11/01/2020 to 10/31/2022 by determining AMH, antral follicle count, and FSH determination. The participants were recruited during the follow-up of the long-term effects of cancer treatment. Descriptive statistics were presented.

Results: 71 pubertal and young adult patients were evaluated, 40 had the cancer diagnosis being prepubertal (56.3%) and 31 after having started puberty (43.7%). The median age at the start of cancer treatment was 8.1 years (0.9-17.6) and at the end of treatment was 10.1 years (2.1-20.3). The median of follow-up was 11.8 years (5-25) and at evaluation 19.9 years (10.8-31.9). The diagnosis was ALL in 59.2%, Hodgkin’s lymphoma in 11.3%, AML in 7% 53% received only chemotherapy treatment (CMT), 15.5% (CMT+RT); 15.5% (CMT + surgery). All participants who received BMT (8.4%) as part of their treatment had ovarian function and follicular reserve impairment. Thirteen patients had at least one pregnancy prior to evaluation, 3 of which became pregnant twice and 1 had a twin pregnancy. Of the 17 gestational products: 6 were TNB (4 AGA, 2 SGA), 8 PTNB (4 AGA, 4 SGA), 2 spontaneous abortions (9 and 11 weeks), and 1 legal pregnancy interruption (12 weeks). The age of the first pregnancy was 18.8 (15.2-23) years. 18.3% managed to conceive without using assisted reproduction techniques. Two of the patients who subsequently became pregnant had AMH values < 1 ng/ml and none of the patients who achieved pregnancy had FSH values ≥25 IU/L.

Conclusion: In our study, 18.3% of cancer survivors had a recorded pregnancy. Patients would benefit from more frequent obstetric monitoring to reduce the risk of possible gestational complications.