Successful pregnancies following an egg donation program in women with previously treated Hodgkin's disease

Background and Objectives. In order to draw attention not only to patients affected by a neoplasia, but also to those who may have problems of sterili ty, we describe six women affected by Hodgkin's disease who had precocious menopause due to chemotherapy and/or radiotherapy but who were safely deliv ered of children. These pregnancies were achieved through oocyte donation, in vitro fertilization and intrauterine embryo transfer or oocyte intracyto plasmic insemination. Design and Methods. During natural or iatrogenic menopause, the uterus pres erves its capacity to respond to steroidal hormones and to permit implantat ion and development of an embryo. Our study concerns six young females with iatrogenic menopause caused by treatment of Hodgkin's disease who carried a pregnancy to term, The pregnancies were achieved by oocyte donation, in v itro fertilization and intrauterine embryo transfer or oocyte intracytoplas mic insemination. Endometrial maturation was obtained by administration of estradiol and progesterone, Steroidal therapy was administered until the 13 (th)-14(th) week in relation to placental function. Results. Five of the 6 females underwent Caesarean section because of a twi n birth or complications during the third trimester of pregnancy (gestosis) . All the delivered children are, to date, well; their median age is 4 year s. Interpretation and Conclusions. This study confirms the possibility of wome n treated for Hodkin's disease being able to carry a pregnancy safely to te rm with the help of steroidal therapy. Careful clinical and obstetric surve illance is Important. Focusing attention on long-term survivors of Hodgkin' s disease, we set the goal of improving the quality of life of these patien ts, considering their psychophysical well-being as a whole. Greater attenti on to the problems of safeguarding fertility in these patients would be adv isable, also in the light of legislative regulation of medical care techniq ues in various countries. (C) 2001, Ferrata Storti Foundation.