Thursday, October 29, 2009

Fertility Possible After Chemo and Radio Therapy


Question:
Hi, I am a 29 year old women who suffered 5 years ago colorectal cancer. I went trhough radio/chemo treatment, and I also got my ovaries moved up to avoid direct exposure to radio, I also got a monthy injection to protect my overies from chemo, finally I got surgery with result of a permanent colostomy. I got recently interested in knowing my possibilities of pregnancy, and just made hormonal blood test. That was made on the first day of my menstruation, and results are: LH 7.17 mUI/ml, FSH 12.5 mUI/mL; Beta Estradiol 29.2 pg/mL and prolactina 13.4 ng/mL. I have not gone to my ginecologist yet, but seems like my FSH is a little bit too high. Can anyone give me a glimpse if I am allright?
Cheers, CE from Spain

Answer:

Hello CE from Spain,

Based on your hormone tests, you still have normal ovarian function. That is, you are still ovulatory. However, the FSH level is elevated from a fertility point of view. We generally like the FSH level to be 7 or less. We worry when it reaches 10 or above. This elevated FSH level normally indicates that the ovaries would be resistant to stimulation if IVF were performed. What that means is that even with high dose fertility medications (which is FSH), the ovary may not stimulate well and few eggs would be retrieved. It is also an indication that time is not on your side so if you are going to get pregnant, you should do it soon.

The analogy I use for patients to explain FSH levels is like this: Imagine that the ovary is a ball with lots of holes in it (like a golf practice ball) so that it allows fluid to easily pass through into the center. That fluid is FSH. Now, imagine that more and more of those holes get blocked, so that less and less FSH can get into the middle. That would then leave more and more FSH on the outside (your blood), so that the levels increase. That is basically what is happening.

The other worry I would have with your history is the egg quality. Although precautions were taken to try to preserve the eggs from harm from radiation, chemotherapy can also damage the eggs, so that may be a major deterrent to getting pregnant.

Sincerely,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program

Monterey, California, U.S.A.

check me out on facebook and twitter with me at @montereybayivf

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