- Question from Susan: So if one's menstruation does not start again after chemo, then you mean you can still be fertile? If so, how is that tested?
Kutluk Oktay, M.D.
In many chemo drugs, even the ones we think are not that harmful, there may be a temporary cessation of menstruation. That's simply because the one or two eggs that have grown enough to make hormones are the ones that cause menstruation, and they're sensitive to any treatment. So the fact that menstruation stops does not mean the damage is irreversible.
But if menstruation has not come back after six to twelve months, the likelihood of permanent damage is higher, and it's a sign that the reserve eggs may also have been damaged. So if you received chemotherapy in the past six months and your period has not started again, we would wait for a year and also measure your follicle stimulating hormone levels to determine if your ovaries are recovering—or, more correctly, to see if you have a number of eggs left that continue to function.
- Marisa Weiss, M.D. How reliable are blood levels of FSH/LH and estradiol in predicting whether someone is in permanent or temporary menopause?
- Kutluk Oktay, M.D. They're good at predicting the bad news, but not as good at predicting the good news. If the levels are normal, they don't tell the number of reserve eggs. If they're raised, that pretty well tells us the reserve eggs are damaged. So if a patient has elevated FSH levels after one year, that's a pretty good indication that ovarian damage has occurred.
On Wednesday, August 18, 2004, our Ask-the-Expert Online Conference was called Pregnancy and Fertility Issues. Kutluk Oktay, M.D., Leslie Schover, Ph.D., and moderator Marisa Weiss, M.D. answered your questions about pregnancy and fertility before, during, and after breast cancer treatment, as well as the options of adoption and gestational carriers (surrogate mothers).
The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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