Contraception after cancer treatment: describing methods, counseling, and unintended pregnancy risk
Contraception after cancer treatment: describing methods, counseling, and unintended pregnancy risk
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DOI：
10.1016/j.contraception.2014.01.014
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发表时间：
2014-05-01
期刊：
影响因子：
2.9
通讯作者：
Rosen, Mitchell P.
中科院分区：
文献类型：
--
作者：
Quinn, Molly M.;Letourneau, Joseph M.;Rosen, Mitchell P.
目的：我们的目的是描述年轻女性癌症幸存者使用的避孕方法，并确定是否治疗前生育咨询降低意外怀孕risk.Methods：1041 nongynecologic癌症幸存者18岁至40岁之间的回答调查生殖健康，使用的避孕方法和生育咨询癌症治疗前的历史。治疗后月经出血恢复且未接受手术绝育的受试者，如果在前一个月报告无保护阴道性交但不希望受孕，则被定义为存在意外妊娠风险。使用的统计方法是Student t检验和chi（2）。结果：总体而言，918名女性（88%）接受了可能影响生育能力的治疗（化疗、放疗或绝育手术）。在476名40岁以下仍有月经的女性中，58%的人不想怀孕;在这275名女性中，21%的人报告在前一个月进行了无保护的性交，并被定义为有意外怀孕的风险。相比之下，国家卫生统计中心报告的意外怀孕风险为7.3%。年龄增加与意外怀孕的风险增加相关（比值比1.07，p=.006）。报告了以下避孕方法：屏障（25.5%）、激素（24.5%）、输卵管结扎（21.3%）、输精管切除术（17.5%）、宫内节育器（7.2%）和其他（4.0%）。67%的妇女在治疗前接受了生育咨询。治疗前的咨询并没有降低意外怀孕的风险（p= 0.93）。结论：与美国人群相比，性活跃的癌症幸存者意外怀孕的风险增加了三倍。避孕咨询，在这一高风险的人群，建议posttreatment.Implications：性活跃的癌症幸存者在相当大的风险意外怀孕。患者报告的关于生育的预处理咨询与意外怀孕风险的下降无关，强调了关于咨询内容和时间的明确建议的重要性。(C)2014 Elsevier Inc. All rights reserved.
Objective: The objective was to describe contraceptive methods utilized by young female cancer survivors and determine whether pretreatment fertility counseling decreases unintended pregnancy risk.Methods: One thousand and forty-one nongynecologic cancer survivors between18 and 40 years of age responded to a survey of reproductive health, contraceptive methods utilized and history of fertility counseling before cancer treatment. Subjects who had resumed menstrual bleeding following treatment and had not undergone surgical sterilization were defined at risk of unintended pregnancy if they reported unprotected vaginal intercourse in the prior month but did not desire conception. Statistical methods utilized were Student's t test and chi(2).Results: Overall, 918 women (88%) received treatment with potential to affect fertility (chemotherapy, radiation or sterilizing surgery). Of 476 women younger than 40 years old who still had menses, 58% did not want to conceive; of these 275 women, 21% reported unprotected intercourse in the prior month and were defined at risk of unintended pregnancy. This compares to the 7.3% risk of unintended pregnancy reported by the National Center for Health Statistics. Increasing age was associated with greater risk of unintended pregnancy (odds ratio 1.07, p=.006). The following contraceptive methods were reported: barrier (25.5%), hormonal (24.5%), tubal ligation (21.3%) vasectomy (17.5%), intrauterine device (7.2%) and other (4.0%). Sixty-seven percent of women received pretreatment fertility counseling.Counseling prior to treatment did not decrease risk of unintended pregnancy (p=.93). Conclusions: Sexually active cancer survivors are at threefold increased risk of unintended pregnancy compared to the US population. Contraceptive counseling in this high-risk population is recommended posttreatment.Implications: Sexually active cancer survivors are at considerable risk of unintended pregnancy. Patient report of pretreatment counseling regarding fertility was not associated with a decline in risk of unintended pregnancy, highlighting the importance of clear recommendations regarding content and timing of counseling. (C) 2014 Elsevier Inc. All rights reserved.