Fertility in Female Thyroid Cancer Patients
2The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel
3Dept. of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University
4Sackler School of Medicine, Tel Aviv University
Introduction:
Thyroid cancer (TC) is frequently found in young women. Concerns have been raised about the impact of TC diagnosis and radioactive iodine therapy (RAIRx) on reproductive function.
Aim:
To evaluate the effects of TC diagnosis and RAIRx on infertility (IF) and pregnancy-rates.
Methods:
The Clalit-Health-Medical-Organization computerized-database was screened to identify women diagnosed with TC at age≤40 years between 2000-2020. Rates of IF (defined as IF diagnosis and/or purchase of specific IF medications) and pregnancy after TC were compared to age-matched healthy women.
Results:
Study included 1309 women aged 30.1±6.34 years at TC diagnosis, followed for 10.8±5.7 years [680(51.9%) received RAIRx], and 5247 controls.
IF-rate in TC-patients was higher than in controls (22.9% vs. 19.8%, p=0.01), while their pregnancy-rates were comparable (44.9%/46.5%, p=0.35). Yet, in the lowest age-quartile (Time to first forthcoming pregnancy in TC-patients was longer than in controls (49.1±42.1 vs. 44.2±42.2 months, P<0.001).
Among TC-patients, IF and pregnancy rates were similar in women who received/didn`t receive RAIRx, but time to first forthcoming pregnancy was longer after RAIRx(56.1±42.4 vs 40.2±40.2 months, p<0.001).
Conclusions:
Our study provides reassuring evidence about the reproductive characteristics of TC-treated women. Despite a higher IF-rate and longer time to conceive (specifically in the RAI-treated women), pregnancy-rates were comparable to healthy controls. The lower pregnancy-rate in the youngest group could be attributed to psychological/social effects of cancer diagnosis at young age rather than to TC treatment.
