Scientists Predict Risk of Infertility in Women Treated for Hodgkin Disease

Doctors have long known that some women, especially younger women, develop fertility problems as a result of treatment for Hodgkin disease. Specifically, some treatments lead to early menopause, which reduces or takes away the ability to have children. Now researchers at The Institute of Cancer Research in London have led a study that can be used to help determine the risk of early menopause from specific treatment types and doses. This personalized information, including age at which to expect early menopause, may help women and their doctors make more informed decisions about treatment and family planning.

The study was published in the September 2014 issue of the Journal of the National Cancer Institute.

Researchers from across the United Kingdom studied the records of 2,127 women under age 36 who had been treated for Hodgkin disease in England and Wales between 1960 and 2004. The women had all received radiation to the chest, and some also received chemotherapy and/or pelvic radiation that reached the ovaries. Out of the group, 605 went through menopause before age 40.

The researchers used data from the study to create a risk table that estimates the risk of early menopause based on a woman’s age and treatment type.

According to the table, in young women who get a 4-drug combination called ABVD, the most common chemotherapy regimen in the US, the risk of going through menopause by age 40 is only about 1%.

However, in young women getting a different chemotherapy regimen known as BEAM, the risk of menopause by age 40 is 75%. The risk with other regimens containing chemo drugs called alkylating agents is 49%, and the risk with alkylating agents plus pelvic radiation is 93%.

Treatment for Hodgkin disease has advanced a great deal during the 40 years covered by the study. So it’s likely someone diagnosed with Hodgkin disease today would be treated differently from someone who was diagnosed decades ago. Doctors have learned more about the risks of long-term side effects, including fertility problems, and today treat people with lower doses of radiation and different chemotherapy regimens to provide the most effective treatment with the fewest side effects.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

 Risk of Premature Menopause After Treatment for Hodgkin’s Lymphoma. Published in the September 2014 issue of the Journal of the National Cancer Institute. First author Anthony J. Swerdlow, DSc, Institute of Cancer Research, Sutton, England.

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