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New Drug Offers Hope for Pregnancy for Women Post-Chemo

Katlyn Joy | 6, June 2014


A new study presented in May at the American Society of Clinical Oncology in Chicago offers hope to women who have undergone chemotherapy. The drug is goserelin, a hormone-suppressing drug injected for the purpose of lowering estrogen and suppressing menstruation.

The study shows that using the drug causes the women's bodies to essentially turn off their ovaries during their chemotherapy treatment. The ovaries produce estrogen and then produce an egg each month as part of a normal cycle.

Often women facing chemotherapy for treatment of breast cancer and the one of the most devastating side-effects is early menopause, which results in loss of fertility, and an increased risk of osteoporosis and broken bones.

For the study, which was funded by the National Institutes of Health, 218 women ages 18 to 49 who were taking the same chemotherapy regimen were studied for two years. Of the women, some were randomly selected for a trial of goserelin.

The results were dramatic; women who took the drug were 50 percent more likely to be alive four years after breast cancer treatment. In looking at the group 2 years later, those taking goserelin were 64 percent less likely to have ovarian failure, which is when women have a cessation of six months or more of their menstrual period. Only 8 percent of those receiving the drug have ovarian failure versus 22 percent of the women who didn't get the medication.

The big hope for breast cancer survivors who want to have children, is that those who took the drug were twice as likely to get pregnant after chemo. Of those taking goserelin, 22 percent became pregnant and 15 percent gave birth. This is in stark contrast to those who didn't get the drug; only 11 percent of them became pregnant, and only 7 percent gave birth to a child. Equal numbers in both groups were trying to conceive.

Lead author of the study, Halle Moore, who is an oncologist at the Cleveland Clinic stated, "Premenopausal women beginning chemotherapy for early breast cancer should consider this new option."

The president of the American Society of Clinical Oncology believes the test results have effects that reach beyond breast cancer patients, however. Clifford Hudis says, "The technique would likely benefit women being treated for other kinds of cancer."

For this study women whose type of cancer were fueled by hormones were included exclusively.

Close to 11,000 young women ages 40 and under are diagnosed with invasive breast cancer each year. Traditionally the only hope for such women to have babies later was to harvest and store ovarian tissue or embryos. This is a costly procedure and one that doesn't work well for those who do not have a partner at the time of their cancer diagnosis.

While goserelin had been indicated as being helpful in previous studies, this study may be the push for cancer specialists to recommend it to women looking at breast cancer chemotherapy treatments.

It's hypothesized that the drug helps protect the ovaries by turning them off, and keeping them undetected by the chemotherapy, which targets cells that grow and divide.

Regarding fertility rates among breast cancer survivors he states, "Let's say a woman received a chemotherapy regimen that contained cyclophosphamide at age 30. After chemotherapy, her egg reserve would be comparable to somebody at age 40 who has not had chemotherapy," says Dr. Kutluk Okta, a breast cancer expert and director of the division of reproductive medicine and infertility at New York Medical College/Westchester Medical Center.

The research also found that women having an IVF (in vitro fertilization) procedure performed, the chances of her becoming pregnant after chemotherapy were four times lower. Oktay states, "For example, live birth rates for women under age 30 can be as high as 60-65 percent but if they receive chemotherapy it drops to 15 percent or less per try. For a woman age 40 or older this chance is around 15-20 percent if no chemotherapy is received and 0-5 percent if chemotherapy is received."

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