Current estimates of the impact of chemotherapy on women’s reproductive health are too low, according to a University of California, San Francisco (UCSF) study. The researchers say their analysis of the age-specific, long-term effects of chemotherapy provides new insights that will help patients and clinicians make more informed decisions about future reproductive options, such as egg harvesting.
Previous studies largely have focused on amenorrhea, or the lack of menstruation shortly after treatment, as the primary reproductive side effect of chemotherapy. In this analysis, the researchers also focused on longer-term, age-specific outcomes associated with chemotherapy, including infertility and early menopause. They also noted that the younger a woman is when diagnosed with cancer, the more likely she will experience early menopause.
“We found chemotherapy essentially narrows a woman’s reproductive window by causing a range of damage to the ovaries, even if her menses resume after chemotherapy,” said Mitchell Rosen, MD, senior author and assistant professor in the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences.
Many of the women who responded to the survey had been told that as long as their periods came back, they would have no negative impact from treatment, he said.
“We currently make recommendations on preserving fertility based on limited data. These new findings, which also take into account cancer type and age, hopefully will enable us to offer more strategic and personalized counseling,” said Rosen, who also is director of the UCSF Fertility Preservation Center.
The study is available online in the journal Cancer.
The researchers used the California Cancer Registry, a statewide population-based cancer surveillance system, to ask women about their reproductive history before and after cancer treatment. Survey questions addressed acute ovarian failure (cessation of menses after treatment), early menopause (menopause before 45 years old), and infertility (failed conception).
Read more at Karin Rush-Monroe, Public Affairs