Holly Hoefgen

Risk for Unplanned Pregnancy Among Survivors of Childhood Cancer

ABSTRACTThe purpose of this study was to identify factors associated with risk for unplanned pregnancy in sexually active female survivors using self‐report survey data. Risk for unplanned pregnancy was defined as using less effective/no contraception while also not desiring pregnancy. Of N = 160 participants (age 24.0 ± 3.1 years), 33.1% were at‐risk for unplanned pregnancy. On multivariable analysis, participants were less likely to be categorized at‐risk for unplanned pregnancy if they reported diagnosis of ovarian failure/premature menopause (odds ratio [OR] 0.16, 95% confidence interval [CI] 0.02–0.72, p = 0.032), greater concerns about fertility (OR 0.59, 95%CI 0.43–0.80, p = 0.001), and religious identity of agnostic/atheist (compared with Christian, OR 0.10, 95%CI 0.01–0.41, p = 0.005).

Reproductive late effects after hematopoietic stem cell transplant in pediatric, adolescent, and young adult cancer survivors

AbstractReproductive late effects after hematopoietic stem cell transplant can have a significant impact on cancer survivors’ quality of life. Potential late effects include gonadal insufficiency, genital graft‐versus‐host disease, uterine injury, psychosexual dysfunction, and an increased risk of breast and cervical cancer in patients treated with total body irradiation. Despite guidelines, screening and treatment are not standardized among at‐risk patients. Provider barriers include lack of knowledge of at‐risk therapies and evidenced‐based guidelines. Patient barriers include a reluctance to report symptoms and lack of awareness of treatment options. System barriers include inefficient implementation of screening tools and poor dissemination of guidelines to providers who serve as the medical home for survivors. This review guides the clinician in identifying and managing reproductive late effects after hematopoietic stem cell transplant to improve outcomes.