Menstrual and reproductive function after treatment with combination chemotherapy for malignant ovarian germ cell tumors

Forty patients who had been treated for malignant ovarian germ cell tumors completed a questionnaire designed to evaluate their menstrual and reproductive function. All patients met the following elegibility criteria: (1) successful treatment with combination chemotherapy, and (2) retention of a normal contralateral ovary and uterus. Median age at diagnosis was 15 years (range, 6 to 29), and median age at the time of interview was 25.5 years (range, 14 to 40). Patients had received a variety of chemotherapeutic regimens, the most common of which was a combination of vincristine, dactinomycin, and cyclophosphamide (N = 28). Since discontinuation of chemotherapy, one patient remains premenarchal, and 27 patients have maintained regular menses. The other 12 patients have had menstrual difficulties, but in only three were the problems considered to be serious. Of the 16 patients who have attempted to become pregnant since completing chemotherapy, 11 have delivered 22 healthy infants, non of whom had major birth defects. Only one patient has had persistent problems with infertility. In summary, it appears that the majority of patients who receive combination chemotherapy for malignant ovarian germ cell tumors can anticipate normal menstrual function and a reasonable probability of having normal offspring.