Protecting the ovaries during chemotherapy
There are some medications that may protect the ovaries from damage at the time of chemotherapy.
These medications are called GnRH analogues and temporarily shut down the ovaries, similar to a temporary menopause.
There are several small studies that have shown that the medication may reduce the chance of ovarian failure by up to 40 per cent. For example, if the risk of ovarian failure with chemotherapy was 40 per cent, the risk when the extra medication is used is only about 24 per cent. Unfortunately, this medication currently can be very expensive, depending on an individual patient’s particular medical situation.
These are given as a monthly injection as they are long-acting. In some recent studies, it appears that GnRH agonists protect the ovarian follicles and eggs from the toxic effects of the chemotherapy drugs.
The injections ideally start from about 7 to 10 days before the first dose of chemotherapy (and patients have an injection every 28 to 30 days), but if necessary, the first injection can be given up until the first day of chemotherapy.
The side effects include hot flushes and mood changes. If they are used for more than six months, there is a risk of thinning of the bones (osteoporosis). If the chemotherapy treatment lasts longer than a six month period, then some extra oestrogen replacement may be given to protect against osteoporosis.
Egg and embryo donation
For women who have developed ovarian failure following their chemotherapy/radiotherapy, donor eggs or embryos may be the only option for having a baby. Most IVF units have an active egg donation program and some have an embryo donation program. Many units have long waiting lists for people requiring anonymous donor eggs and embryos. Therefore, many women and couples choose to use a known egg donor, or to seek an egg donor with assistance.
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