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Infertility/Fertility/R-CHOP Chemotherapy Treatment

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Question
I am 34 year old female in Cincinnati, OH.  I have been diagnosed with Diffuse Large B-Cell Lymphoma and my chemotherapy treatment is scheduled to start in 2 days.  My oncologist said that the R-CHOP regimen (I will be getting 3-6 treatments) will have a risk of infertility, but at my age, he believes the risk to be low and recommends immediate treatment.   

My research on-line leads me to believe that R-CHOP is a lower dose of cyclophosphamide (which causes infertility) than other chemotherapy treatments, and that my ability to have a child after chemotherapy is promising.  

I have already had one child (delivered 7 months ago), and got pregnant very easily. I am currently breastfeeding and not menstruating yet.  My question is how much will the R-CHOP regimen specifically put me at risk of infertility?  In addition, if I chose to freeze embryos to preserve fertility, how much time would that take considering that I am not yet having periods?

I have tried to get in to see a fertility doctor, but cannot with the short time frame before my chemotherapy starts.  Any advice you can provide would be greatly appreciated.

Answer
Hello Daisy from the U.S. (Ohio),

I can't answer your specific question regarding the effects of Cyclophosphamide since I am not an oncologist nor pharmacist.  They might be able to answer the question.  However, the problem with chemotherapy is a negative effect on the eggs/egg quality.  Therefore, the reproductive recommendation is to strongly consider banking your eggs.  The egg banking technology has gotten very good and has yielded very good pregnancy results.

In general, IVF cycles are preceded by one month of birth control pills in order to take control of the ovary and therefore control the reproductive cycle.  However, it can be done quicker, as in a natural cycle or if you are breastfeeding, then immediately.  The process takes two weeks to harvest the eggs.  I would strongly recommend that you seek out a good IVF center immediately, even if you have to fly to California to do it.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
info@montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate.  I also now provide an Email Concierge Advisory Service with a 1 year subscription for patients that want easy access to me to answer questions along their journey (women's health, infertility, pregnancy).  Contact me at ejrmd@montereybayivf.com if you are interested in continuous access to me.

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Edward Joseph Ramirez, MD, FACOG

Expertise

I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.

Experience

I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

Organizations
American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

Publications
American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Education/Credentials
Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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