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Cancer Therapy and Later Ovarian Function / Fertility

April 11, 2014

This article is addressing what we have seen for years and what has been misunderstood by much of the cancer treatment community. Chemotherapy, the intense regimens used to treat most common cancers of younger people, destroys cells that are reproducing. Egg cells, while not reproducing on a regular basis, are unusual in that they are frozen in mid-cell division from puberty until they are recruited for ovulation later. Remember women are born with all their eggs and don’t “make more” during their lifetime. Cell division makes the DNA more susceptible to injury from outside toxic influences. Chemotherapy is one of those clear influences. What we now know from the diminished ovarian reserve patient (mostly caused by endometriosis) is regular menstruation clearly does not correlate with fertility. Even women in their late 40′s have regular menstruation but pregnancy is rare. The earlier thought on chemotherapy and ovarian function was that if menstruation returned after chemotherapy that fertility was “normal.” This study helps us understand that this prior notion is not the case.

Women experience menopause when they run out of eggs. Diminished ovarian reserve is essentially a situation where there are fewer eggs present in the ovary than expected for age. The most common cause of more rapid egg loss in our opinion is endometriosis (present in 15-20% of women), followed by smoking, chemotherapy and radiation. Early menopause would be expected as described in the article due to fewer eggs left in the ovary. We see this in each of the above conditions. Women facing the challenges of chemotherapy or radiation for cancer should be carefully counseled on fertility preservation maneuvers prior to treatment. We offer this service with rapid treatment sequence as necessary.

For more information contact our office (904) 493-2229.

Here’s a link to an abstract of the research study mentioned in the article:

Original Article:

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