The long-term effects of the Holocaust on the reproductive function of female survivors

STUDY OBJECTIVE: The aim of this study was to evaluate the effect of internment in the German camps during World War II on menstrual function; future fertility; and, ultimately, on diseases or future surgery needs. SUBJECTS: Five hundred eighty Hungarian female survivors of concentration camps. INTERVENTION: Menstrual and reproductive histories of the women were obtained and analyzed, histories and events from pre-internment, internment, and post-internment periods of time. MEASUREMENTS AND MAIN RESULTS: The mean age of the survivors at the time of internment 23.4 +/- 8.0 years (95% Cl 22.7-24.1). Amenorrhea occurred in 94.8% of the women during (95% Cl 92.7%-96.5%), with 82.4% experiencing cessation of menses immediately internment (95% Cl 76.9%-85.6%). Only 0.6% of women (95% Cl 0.12%-1.63%) menstruated longer than 4 months after internment. After liberation, all but 8.9% of the women resumed within the first year (95% Cl 88.4%-93.3%). Fecundity subsequent to liberation was significantly affected by the imprisonment nor was there a significant increase in spontaneous ectopic pregnancies, stillbirths, or other pregnancy complications. Additionally, there no evidence of impact on the subsequent frequency of gynecologic diseases or surgical procedures. CONCLUSIONS: Imprisonment in German concentration camps during the Holocaust resulted in emotional and psychological changes in the survivors. In addition, this study reveals abrupt in short-term menstrual function but little long-term physical damage to reproductive function. (c) 2007 AAGL. All rights reserved.