Cancer treatment has ended

It is difficult to predict when your menstrual cycle will spontaneously recover after cancer therapy. There is important variation among women and this variation depends on several factors, such as the dose of chemotherapy, your age, the remaining egg cell reserve, etc. Your menstrual cycle may not resume for several months, sometimes even longer.
Of course it is usually a beneficial sign if your menstrual cycle starts again after finishing cancer treatment. But even then, we cannot just assume that your reproductive function is fully back to normal. You may well have a regular menstrual cycle for some time but still have a risk of early menopause. The use of hormonal birth control methods may also mask the occurrence of premature menopause.
In order to draw firm conclusions about the status of your fertility, additional blood tests and an ultrasound scan of the ovaries are required.

A blood test allows us to define a detailed hormonal profile. The most important parameters we measure are FSH and AMH (Anti-Müllerian hormone).
FSH (follicle-stimulating hormone) is the hormone which stimulate the egg cells to mature in the ovaries. If the blood test shows a normal FSH value, this indicates that egg cell maturation is likely to occur properly. The AMH level gives information about how many primordial follicles are left in the ovaries.
After the blood test we will check these results against a follicle count performed by means of a transvaginal ultrasound scan of the ovaries. The CRG gynaecologist will discuss the results of both analyses with you and discuss potential treatment approaches.

If the tests after your cancer treatment reveal that your ovaries are working properly, it is important to have these tests done regularly. You are at risk of reaching menopause much quicker than women who never had cancer treatment, because your egg cell reserve may have been affected.
The Oncofertility team recommends not to delay your attempts to have children but to go for it as soon as your health condition allows you to get pregnant. In practice this will mean that approximately two years will elapse between the end of cancer treatment and your active attempts to become pregnant. However, this interval depends on the type of cancer you had and should be discussed with your oncologist.

If your menstrual cycle resumes after cancer treatment, but you are not (by far) up to having children, you have another option to protect yourself against the risk of early menopause. You may want to undergo a partial fertility treatment, comprising hormonal stimulation of the ovaries, followed by an egg cell pick-up and cryopreservation of egg cells.
If you have a partner with whom you want to have children, you may also have the egg cells fertilized by his sperm and freeze the resulting embryos.
See The cancer treatment is about to start.

Please note! The Oncofertility team will not start up hormonal stimulation before receiving the go ahead from your oncologist or haematologist.