Imminent ovarian failure in childhood cancer survivors

The aim of this study was to investigate reproductive history and the prevalence of imminent ovarian failure (IOF) in female childhood cancer survivors. Reproductive history and ovarian function were evaluated by questionnaires (n = 124) and by measurement of follicle stimulating hormone (FSH) and oestradiol (E2) levels (n = 93). IOF was defined as FSH > 10 IU/l or E2 > 0.28 nmol/l on day 3 of the menstrual cycle, or FSH > 12.4 IU/l on day 7 of the pill-free interval. IOF was demonstrated in 22.6% of the participants and correlated with age at diagnosis (P < 0.005) and age at study (P = 0.036). IOF correlated inversely with methotrexate (P = 0.046). The incidence of miscarriages (22.7%) and recurrent miscarriages (7.3%) was increased. The male/female (M/F) ratio of the offspring was decreased. In conclusion, female childhood cancer survivors are at risk for IOF. If pregnant, the risk of (recurrent) miscarriages is increased. The M/F ratio in the offspring is decreased.