Fertility in female cancer survivors: a systematic review and meta-analysis

Abstract Several epidemiological studies investigated the effects of cancer therapies on fertility. However, conflicting data have been reported. The present systematic review and meta-analysis aims to determine the chances of childbirth in women survived from different types of cancer. We systematically searched Pubmed, MEDLINE, Embase and Scopus, from database inception to July 17, 2019, for published cohort, case-control and cross sectional studies that investigated the reproductive chances in women survived from different types of cancer. Using random-effects models, we estimated the pooled childbirth hazard ratios (HRs), relative risks (RRs), rate ratios (RaRs) and odds ratios (ORs) and 95% CIs. Our search identified 18 eligible studies. Childbirth chances resulted significantly reduced in women with a history of bone cancer (HR 0.86, 95%CI [0.77-0.97]; I2=0%; p=0.02; RaR 0.76, 95%CI [0.61-0.95]; I2=69%; p=0.01), breast cancer (HR 0.74, 95%CI [0.61-0.90]; RaR 0.51, 95%CI [0.47-0.57]; I2=0%; p In conclusion, women with a history of bone, breast, brain or kidney cancer have reduced chances of childbirth. Thyroid cancer, melanoma and Non-Hodgkin lymphoma survivors can conversely be reassured.