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Thread: Cyclophosphamide and fertility

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    Default Cyclophosphamide and fertility

    I've just started my cyclophosphamide treatment, only one dose and was wondering what females have been advised about preserving fertility?

    I have an appointment regarding it tomorrow. I'm 29.

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    Make sure you are on a strong birth control! I was not taking anything when I originally started the cyclo, but my doctor put me on the birth control shot (Depo-Provera) as soon as I could see her after I got out of the hospital. It's still going to be hit-or-miss from my understanding when I do get off the meds and try having kids, but you want to be taking something that can somewhat protect your ovaries and other organs while you're on the cyclo.
    Talk to your rheumy and make sure you have a good OBGYN with Weggie experience.
    Elizabeth J.
    Officially a Weggie since April 2007

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    When I was originally put on that drug my Immunologist and Rheumy both discussed the option of storing my eggs as there is a chance of infertility. It something I'm sure they will cover in your appointment and it is something you need to consider....for me I was already reeling from being diagnosed with WG and had just come out of weeks in hospital being poked and prodded and so did not even want to contemplate any more thoughts of more things being done to me.

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    I'm going through the same dilemma - I was not given the chance to preserve any eggs before starting cyclo because I was just too ill and as I was already on the depo-provera contraceptive injection it would have taken many months for my body to start producing eggs that could be harvested. I'd have died waiting! I do thoroughly recommend a reliable form of contraception while on any of the immuno-suppressive drugs like cyclophosphamide, azathioprine, cellcept etc. I've been on all of them and they all state you cannot get pregnant while taking them because of the damage they cause to the foetus.

    I basically have to wait until I'm in remission or it is possible that I may be able to have some Rituximab which could give me a small window of being able to conceive. I'm 26 and not ready yet, but I just have to cross my fingers that I am still fertile and deal with the issue when I'm in a position to have a child.

    The way cyclophosphamide makes you infertile is by inducing an early menopause, so there's a good chance if you're young enough that you'll still be able to conceive for a few years before the menopause sets in at say 35 instead of 45.

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    I know the thread is mainly aimed at women, but I thought I would chip in and add that the cyclo. made me sterile, but my adopted daughters are wonderful!

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    I have two adopted children too. The doctors were against it because of my kidney transplant and hypertension. I am very happy and blessed to have these beautiful children in my life!

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    Thanks for your replies. I would certainly be keen to consider adoption. My sister is a foster parent.

    I went to the doctors today and have been told it is really too late to take eggs for storage now as I've already started treatment. Anyway, my doctor was not so enthusiastic about egg storage working anyway- it is better to store embryos if you are going to do it as they are more viable. We agreed I will have the monthly injections to try to protect my ovaries before each does of cyclo. Apparently this is still quite experimental in that they don't know for sure it works, but it won't do any harm to have them.

    They said the chances of an early menopause are very high and it would be mostly a case of wait and see after I've finished treatment.

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    My daughter was 25 when she got WG.

    After going into remission and having done cyclo her WG doctor told her no way to having a baby.

    Against his wishes she gave birth in 2008 to a healthy baby boy. It was a high risk preg but everything worked out fine. Luca was born early at 6 months.

    This year Tracey got preg again and miscarried after 7 weeks. She came out of remission in November and has started treatments (cyclo) again.

    Mike
    Tracey

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    Sorry to have to say it, but to gamble on a baby's future for the sake of gratifying your own wishes is a very selfish choice to make. I would never dream of having children given the nature of the drugs we take unless I had been "clean" for a long time and had my doctor's approval.

  10. #10
    Doug Guest

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    I agree with you Jack. All children are blessings (until they are teenagers, then there's a sorting-out!), but to go into a pregnancy knowing of the potential risk to the fetus is touching on a very personal moral choice.

    These days, when ultrasounds give us a womb with a view into the developing child's physical and medical issues, a child with severe medical or developmental issues is a high candidate for abortion. People with strong feelings against abortion are apt to carry the child till birth, regardless of the developmental issues. Either way, wow.

    I don't know what the odds are for a full-term "normal" baby for weggies who are on or have been on the classic Cytoxan/Prednisone treatment, if they've even been determined, but anyone considering having a baby before getting a competent doctor's OK (or even with that approval) really needs to sit down with their spouse and deal with the potential for the worst outcome and how well they are able to handle the medical and emotional costs of a premmie with developmental or medical issues OR a baby who dies or is stillborn because of the drugs.

    This is a topic that needs its own thread, above and beyond the question of fertility. It's a real hot potato issue.
    Last edited by Doug; 01-16-2010 at 04:02 AM.

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