Treatment with radioiodine does not decrease
fertility in women with thyroid cancer
(July 2002)
The background of
the study. Some women with thyroid cancer treated with high
doses of radioiodine have transient ovarian dysfunction, but whether
their fertility is reduced is uncertain. In this study the frequency
of menstrual disturbances and pregnancies in women with thyroid
cancer who had been treated with radioiodine was determined.
How the study was done. The study
subjects were 496 women less than 40 years old with papillary or
follicular thyroid cancer who were treated with surgery and then
radioiodine and survived for at least two years thereafter. The
women were asked about their menstrual and obstetric histories and
their desire for children during follow-up visits or by mail.
After surgery, 322 women (65 percent) received a single dose of
radioiodine, and 174 women (35 percent) received multiple doses
because they had persistent or recurrent tumor. The women were advised
not to become pregnant for one year after each treatment.
The results of the study. Eighty-seven
women (18 percent) had died or were lost to follow up. Among the
remaining 409 women, 326 (80 percent) had normal menstrual cycles,
49 (12 percent) had transient menstrual irregularity, and 34 (8
percent) had transient amenorrhea. No woman had permanent amenorrhea.
A total of 133 women (33 percent) reported that they did not want
to have children and used contraception. Among the 276 women (67
percent) who wanted to have children, 275 had a total of 427 children.
The conclusions of the study. In
women with thyroid cancer radioiodine therapy may transiently decrease
ovarian function, but it has no long-term effect on fertility.
The original article. Vini L, Hyer
S, Al-Saadi A, Pratt B, Harmer C. Prognosis for fertility and ovarian
function after treatment with radioiodine for thyroid cancer. Postgrad
Med J 2002;78:92-3.
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