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Fertility After Cancer Treatment

Women who have been treated for cancer or severe rheumatologic and  autoimmune diseases should consider having ovarian reserve testing within 4-6 months after treatment. Current tests for ovarian reserve include:

Hormone Tests

  • FSH and Estradiol  at the beginning of the menstrual cycle
  • Anti-Mullerian Hormone any time during the menstrual cycle
  • Inhibin-B at the beginning of the menstrual cycle

Ovarian Ultrasound

  • Antral Follicle Count at the beginning of the menstrual cycle

Patients who are interested in future fertility should be evaluated for lung, heart, kidney and liver damage due to chemotherapy or radiation therapy prior to pregnancy  

Some patients may have a genetic condition in which the cancer actually runs in the family and can be transmitted from one generation to the next one. We have listed a partial list of some of the genetic syndromes which can lead to familial cancer:

Hereditary Genetic Syndromes

  • Hereditary Breast/Ovarian Cancer (BRCA1 and BRCA2)
  • Familial adenomatous polyposis (Colon Cancer)
  • Hereditary Nonpolyposis Colorectal Cancer
  • Li-Fraumeni Syndrome (Bone, Breast, Brain, Adrenal or Soft-tissue Cancer
  • Multiple Endocrine Neoplasia Type 2A (Thyroid or Adrenal Cancer)
  • Neurofibromatosis 1and 2 (Brain, Spinal, Nerve or Skin Cancer)
  • Retinoblastoma (Eye, Brain, Bone or Skin Cancer)
  • Tuberous Sclerosis (Kidney or Brain Cancer)
  • Von Hippel-Lindau Disease (Kidney, Adrenal or Pancreas Cancer)
  •  Patients with Hereditary Genetic Syndromes may benefit from pre-pregnancy genetic counseling and testing
  • Patients with Hereditary Genetic Syndromes may want to consider In Vitro Fertilization (IVF) with Preimplantation Genetic Diagnosis (PGD) to find out if they have embryos which are carriers for a particular cancer gene so that they may avoid transmission of that gene to their children.
  • Costs: Charges for In Vitro Fertilization (IVF) are about $10,000 plus fertility medication (about $5,000), and Preimplantation Genetic Diagnosis (PGD) charges are about $6,000

Patients who are found to have Premature Ovarian Failure following treatment may want to consider the following options, which were discussed under Fertility Preservation Options:

  • Oocyte donation
  • Embryo donation
  • Adoption

Patients who have conditions in which pregnancy is  contraindicated may want to consider the following options, which were discussed under Fertility Preservation Options:

  • Gestational surrogacy
  • Adoption