QuestionHI. I'm 39 years old (from NJ)and a 1.5 year survivor of Non-Hodgkins Lymphoma. Went through 6 cycles of a chemo regimen called R-Chop and 5 weeks of mediastinal radiation. I had menopause for 9 months post-chemo, then got periods for about 9 months. My last period came on 9/1/08. My doc just tested my estrogen, FSH and LH levels. My levels are as follows:
Estrodial: 29 pg/mL (Range(ref: 19-52.8)
FSH: 90.9 MIU/mL (ref 1-26)
LH: 52 mIU/ML (ref 0-76.3).
I realize that my levels are considered "postmenopausal" but my question is this, is it possible to still get recovery of the FSH and LH post chemotherapy. My chemo regimen is known to bring on early menopsuse, but more likely at age 45 once periods resume. It was not expected that I would have permanent menopause following R-Chop, but I realize that everyone is different. I did not get any testing done when i was getting periods, and now I'm not sure if i was ovulating at all. Is recovery of my ovaries possible. I've read that some women get their periods back after 2 years post chemo. Would I be a candidate for drugs to make me ovulate or IVF using my own eggs.
Thank you for reading my question.
AnswerHello Mary,
Unfortunately, your FSH level shows that you are indeed in menopause. I am not sure that you will get recovery of your ovarian function. If you are wanting pregnancy, even if ovarian function returns, it is unlikely that you would become pregnant because of damage to the eggs. If you are not contemplating pregnancy, then I would begin on a hormone replacement regimen, such as birth control pills, to provide adequate estrogen to your body and not suffer the long-term effects of menopause at a young age. In this case, your cycles will resume because the birth control pills will cycle the uterus regardless of the function of the ovaries.
You are not a candidate for ovulation induction or IVF using your own eggs. The ovulation induction will not work, because your ovaries are shut down. The IVF will not work either because the ovaries are shut down and cannot be stimulated, and because the eggs are no longer viable. In addition, your age plays into the prognosis. You are a candidate for donor eggs/IVF, however, and is the course that I would recommend.
Sorry for the bad news,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
