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Chemotherapy-induced amenorrhea and its effects on fertility in long-term female survivors of classic osteosarcoma

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Abstract

Purpose

To explore the effect of chemotherapy-induced amenorrhea (CIA) on female osteosarcoma patients’ fertility function, we investigated and analyzed their marital status, fertility, and menstrual status in a retrospective cohort study.

Methods

We selected female osteosarcoma patients from database from January 2004 to December 2013. Patients’ characteristics such as age, tumor location, marital status, menstrual status, and fertility status were collected. The data were analyzed using the Statistical Package for the Social Sciences (SPSS), version 22.

Results

A total of 122 female patients met these criteria and finally responded by questionnaire and telephone follow-up. The marriage rate of female osteosarcoma survivors was 50.8% (62/122), which was significantly lower than the control group (p = 0.000). The average marriage age of female osteosarcoma survivors was 25.5, which was obviously higher than the control group (p = 0.000). CIA occurred in 46 (36.1%) patients. We then found that the incidence of CIA was higher in older patients. (p = 0.011). All of the married patients wanted to have children, and 67.8% (42/62) of them had given birth after chemotherapy. The fertility of married patients with CIA was significantly reduced compared to that of married patients without CIA. (p = 0.001).

Conclusions

The patients with CIA have higher risk of impaired reproductive function than those who did not. Fertility preservation option before the start of the chemotherapy is important. And it is much value to record menstrual pattern and detect sex steroid levels after 6 months of therapy in order to be able to evaluate the fertility status.

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Funding

This study was funded by “Beijing Hospitals Authority Youth Programme” (grant number QML20170406).

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Authors and Affiliations

  1. Traditional Medicine, Beijing Jishuitan Hospital, 31 east street of Xinjiekou, Xicheng District, Beijing, China

    Jiang Yang & Gao Yemei

  2. Bone Oncology, Beijing Jishuitan Hospital, 31 east street of Xinjiekou, Xicheng District, Beijing, China

    Huang Zhen, Xu Hairong & Niu Xiaohui

Authors
  1. Jiang Yang
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  2. Huang Zhen
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  3. Xu Hairong
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  4. Gao Yemei
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  5. Niu Xiaohui
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Jiang Yang, Huang Zhen, and Xu Hairong. The first draft of the manuscript was written by Jiang Yang and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Niu Xiaohui.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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All authors are in agreement with the publication of the manuscript.

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The authors declare no conflict of interest.

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Yang, J., Zhen, H., Hairong, X. et al. Chemotherapy-induced amenorrhea and its effects on fertility in long-term female survivors of classic osteosarcoma. Support Care Cancer 29, 5999–6004 (2021). https://doi.org/10.1007/s00520-021-06069-0

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