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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Petru, E; Wildt, L; Stummvoll, W; Singer, C; Speiser, P; Fischerlehner, G; Reitsamer, R; Kubista, E; Marth, C; Winter, R; Menzel, C; Leodolter, S; Seifert, M; Zervomanolakis, I; Zeimet, A; Reinthaller, A.
Consensus of the Austrian Society for Gynecology and Obstetrics/Gynecologic Oncology Working Group Fertility, Contraception and Hormone Replacement Therapy in Oncologic Patients with Special Reference to Breast Cancer
GEBURTSH FRAUENHEILK. 2009; 69(12): 1071-1077.
Doi: 10.1055/s-0029-1240642
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- Leading authors Med Uni Graz
- Petru Edgar
- Co-authors Med Uni Graz
- Winter Raimund
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- Abstract:
- A working group of the OEGGG/AGO presents a consensus statement on fertility, contraception and hormone replacement therapy in oncologic patients. Fertility: Alkylating agents are the most gondadotoxic. Tarnoxifen and aromatase inhibitors exert only a marginal influence on ovarian reserve. GnRH analogues do not damage germ cells. Increasing age is associated with reduced ovarian reserve and the probability of pregnancy. Systemic chemotherapy accelerates the physiological process of reduction of primordial follicles independently of age. Following cytotoxic or antihormonal treatment, ovarian function tests should not take place earlier than 2 months. Biochemical analyses Should be included also. With regard to ovarian reserve, the most reliable parameter is the anti muellerian hormone (AMH; Muellerian Inhibiting factor, MIF) since its value remains stable throughout the cycle. This is not true for FSH and inhibin beta. Data on the medication with GnRH analogues in parallel to chemotherapy for fertility preservation are inconclusive. The method of ovulation inhibition via contraceptives has been shown effective mainly in hematologic diseases such as Hodgkin's disease. Ovarian tissue banking and methods of assisted reproduction can be considered experimental and thus may only be offered in certified centers. Similarly, in vitro fertilisation before chemotherapy ("emergency IVF") is experimental. Contraception: The main methods of contraception can be used by all oncologic patients with the exception of breast cancer in which generally the placement of an intrauterine pessar is recommended. Tarnoxifen is no contraceptive method. If, from the oncologic point of view, GnRH agonists are prescribed, no additional contraception is necessary.
- Find related publications in this database (Keywords)
- fertility
- contraception
- hormone replacement therapy
- oncologic diseases
- breast cancer
- consensus
- ovarian reserve
- chemotherapy
- GnRH analogues