Did Childhood X-Ray's Affect My Fertility? Queries Australian Woman...

Question:

Hi,

I was born with Perthes Disease (a disease of the hip). From the ages 5 - 15 I would have had well over 100 X-rays, concentrated on that area - most taken from above my body looking directly down at my hips.

I have never been able to keep a pregnancy beyond weeks, and tests have come back saying the last one included the extra chromosome 15. I have been under fertility treatment for 2.5 years. Tests are going to be carried out on my latest "failed pregnancy" within the next 4 weeks. The X-rays took place from 1971 - 1986. I have been in 2 long term relationships since 16 years old. (The current one being 13yrs) and there is no history of infertility in my family - all 4 siblings successfully having multiple children. I believe my eggs may have been damaged as a result of these X-Rays.

Regards. K. from Australia

Answer:

Hello K. from Australia,

I have to agree that there could have been egg damage from the proximity of the X-rays that is now causing the embryos to have genetic abnormalities. There is no treatment that can be done to repair eggs, but one option you might want to consider is to do CGH in association with an IVF cycle. With CGH (Comparative Genomic Hybridization), polar body biopsies can be done on the eggs at the time of fertilization and thereby evaluate the genetic complement of the eggs. This will immediately allow you to eliminate the abnormal eggs and hope that there is a normal one that survives and can be transferred. There is always the chance that there are some good eggs left and that is the goal. It may take several IVF attempts before finding that good egg, but in the end it will be well worth it. There is no price you can put on a child.

If you don't want to go through this option, with the potential risks of failure, your alternative then would be to proceed with Donor eggs and IVF.

I was just at a National OB/GYN conference and one of the topics discuss was a new program in the U.S. called Oncofertility Consortium. This is a group of specialists in the field of infertility, oncology, therapists, etc. that are promoting fertility preservation in patients facing various cancers or treatments such as radiation, chemotherapy, etc. The reproductive outlook for women cancer patients is becoming as good as for men, who long have had the option of banking their sperm. It is our hope that patients, such as you, will undergo counseling for fertility preservation and be given the option of preserving your eggs or ovarian tissue prior to undergoing treatments. I know that this is not going to benefit you now, but we hope that it will benefit people like you in the future. For more information on this group from the American College of Ob/Gyn's website, go to: http://bit.ly/axAePh.

Thank you for your question. I will be keeping my fingers crossed for you!

Good Luck,

Edward J. Ramirez, M.D., FACOG

Executive Medical Director

The Fertility and Gynecology Center

Monterey Bay IVF Program

http://www.montereybayivf.com/

Monterey, California, U.S.A.

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.

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