Age at Chemotherapy Linked to Fertility Problems Later

The study covered in this summary was published on as a preprint and has not yet been peer reviewed.

Key Takeaway

  • Among female pediatric patients with cancer, chemotherapy after the age of 12 was associated with premature ovarian insufficiency.

Why This Matters

Study Design

  • The team reviewed 57 young female patients with cancer whose ovarian hormone levels following completion of chemotherapy had been documented and who had entered survivorship programs at Penn State Health from 2008–2017.

  • Patients’ ages ranged from 2–21 years at time of diagnosis, and they were split equally between those diagnosed before age 13 and those diagnosed after that age.

  • Diagnoses included leukemia, Hodgkin’s lymphoma, and solid tumors.

  • To limit confounding, investigators excluded patients who had undergone allogeneic stem cell transplantation as well as those with breast or brain cancer who had received pelvic radiotherapy, among others.

  • Patients who were too young to have their hormone levels checked (ie, those younger than 13 years at the time of chart review) or who had not achieved menarche as of their last clinic visit were also excluded.

Key Results

  • Overall, five patients (9%) met criteria for premature ovarian insufficiency.

  • These patients were all diagnosed with cancer at age 13 or after and had lymphoma or solid tumors.

  • The five patients had received cyclophosphamide equivalent doses of 0–28.4 gm/m2, suggesting that ovarian dysfunction can occur without exposure to cyclophosphamide-equivalent therapy.


  • The study only included five patients with premature ovarian insufficiency.

  • Multiple healthcare providers were involved, and documentation patterns were inconsistent among them.


  • No funding for the study has been reported, and the investigators have disclosed no relevant financial relationships.

This is a summary of a preprint research study, “Variables Associated With Ovarian Insufficiency in Pediatric Oncology Patients Following Chemotherapy,” led by Kaydee Kaiser of Penn State Health Children’s Hospital, Germany, provided to you by Medscape. The study has not been peer reviewed. The full text can be found at

M. Alexander Otto is a physician assistant with a master’s degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who has worked for several major news outlets before joining Medscape and also an MIT Knight Science Journalism fellow. Email: [email protected].

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