A recent article, “Acute Ovarian Failure Underestimages Age-Specific Reproductive Impairment for Young Women Undergoing Chemotherapy for Cancer,” examined the reproductive impairment rates of young cancer survivors, using participants in the California Cancer Registry who had Hodgkin disease, non-Hodgkin lymphoma, gastrointestinal malignancies, and breast cancer. The authors found that chemotherapy caused acute ovarian failure (loss of menstural period) in 3-10% of these survivors, depending on the cancer type, consistent with previous studies. However, infertility was also reported in 18-27% of survivors who resumed menstural periods, bringing the total infertility rate in these survivors to 30% or more.
Interestingly, older age at diagnosis increased the likelyhood of both acute ovarian failure and infertility. In contrast, many women in the study resumed normal periods after chemotherapy but had early-onset menopause (before 45 years old) and the likelyhood of premature menopause increased in women diagnosed at younger ages (30-60% if diagnosed at age 20; 16% if diagnosed at age 35). Hence, younger women, who may be more likely to resume periods and fertility immediately after treatment, should be aware of the pontential for a shortened reproductve timeframe. The authors, Letourneau, Ebbel, Katz, Oktay, McCulloch, Wei, Chien, Melisko, Cedars, and Rosen, state that this data provides more evidence that clinicians should communicate fertility information to cancer patients that includes risks for ovarian failure, infertility, and premature menopause. Read the article in Cancer.