Читать книгу Assisted Reproduction Techniques - Группа авторов - Страница 178

It is not uncommon for women to experience menstrual irregularities or amenorrhea during, and up to 2 years after cancer treatment. Young women with long term drug‐induced amenorrhea may still regain menstruation at the end of treatment. It should be remembered that there is a natural decline in fertility with age, and that although regular menstrual cycles may serve as a marker of ovarian function, they are not synonymous with maintenance of fertility potential as there may still be ovulatory dysfunction. Similarly, irregular menses do not necessarily imply infertility. In young women spontaneous conception can occur despite a very low ovarian reserve and even in the presence of significant oligomenorrhea. However, even where there is apparent ovarian recovery, the ovarian reserve could still be reduced, and the degree of reduction will determine the window of reproductive opportunity that remains.

Failure to resume ovarian function by two years following cessation of chemotherapy is most likely to indicate ovarian failure. However, in some young women recovery may occur several years later and can even occur following a stem cell transplant for relapsed HL which generally has a high risk of ovarian failure.