October 2016

Survivors of Childhood Cancer POI Surveillance Recommendations

This report represents a unique collaborative effort among international specialists in the field of oncology and reproductive medicine. An evidence based approach was used to develop recommendations regarding surveillance for premature ovarian insufficiency in female childhood, adolescent and young adult cancer survivors.  In particular, because females exposed to specific gonadotoxic treatments including alkylating agents and ovarian radiation are at highest risk for ovarian insufficiency, these survivors should be monitored closely before and after puberty. The focus of monitoring should be on growth, pubertal development, assessment of menstrual function and measurement of serum FSH and Estradiol. The authors concluded that AMH may be a reasonable adjunct for assessing ovarian reserve in women at least 25 years of age.

Fertility Drugs and Cancer Guideline Issued by ASRM

Recently the American Society for Reproductive Medicine issued a new guideline assessing the impact of fertility drugs on the risk of cancer in women. This guideline was developed after a comprehensive literature search and grading the available data on this topic. The committee concluded that data in this area are limited by retrospective observational studies which have a variety of methodological problems including: small sample sizes, inadequate information about duration and dose of fertility treatment, and limited follow-up. Moreover, the data are confounded by the fact that some women with infertility are at increased risk of breast, ovarian and endometrial cancer. Nonetheless, there is no compelling data suggesting that fertility medications increase the risk of invasive cancers.