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What are the implications of endocrine treatment for patients who recover ovarian function?
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Nine of 144 women transplanted for leukemia following 120 mg/kg CY and 9.20 to 15.75 Gy total body irradiation (TBI) recovered ovarian function.
Among 708 postpubertal women, 110 recovered normal ovarian function and 32 became pregnant.
Multivariate analysis showed that TBI was the only factor significantly influencing ovarian failure and that both TBI and greater patient age at transplant were significantly associated with a decreased probability of recovering normal ovarian function.
Among 43 women transplanted for aplastic anemia following 200 mg/kg cyclophosphamide (CY), all 27 < 26 years of age, but only five of 16 > 26 years of age recovered normal ovarian function.
When statistical analysis was restricted to patients whose tumors expressed ER and/or PR, the same tendency was observed in the 3FEC/3D group: a statistically significant advantage for patients who were still amenorrheic after one year, compared to those who had recovered premenopausal ovarian function (p < 0.002).
Most of the cortical pieces were transplanted at the orthotopic location into two deep pockets made by scalpel incisions in the remaining right ovary 4. The ovarian function promptly recovered, and spontaneous ovulation was demonstrated for the first time, with confirmation of a postovulatory corpus luteum in the orthotopic transplant by ultrasonography.
Thus, aromatase inhibitors should be used with caution in women with chemotherapy-induced amenorrhea, and serum estradiol and gonadotropin levels should be serially monitored to ensure that ovarian function is not recovering [ 61].
The egg reserve maintains ovarian function.
So far, two patients show signs of ovarian function.
The goal of treatment is to interrupt ovarian function and menstrual bleeding.
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