Concern over fertility

hana123 · August 2006

I'm a 21 year old papillary thyroid cancer patient. I had a total thyroidectomy at 18, and this week I underwent a neck dissection on the right side due to metastases in the lymph nodes. I've also had three rounds of radioactive iodine treatment prior to this surgery.

I have some concerns about what all the radiation might have done to my fertility. When I asked the radiologist at the end of the last round of radioactive iodine in December, she was not particularly informative or optimistic about the outlook.

In addition, I'm getting to the point where I'd like to start a serious relationship and look to the future, but I'm not sure where to begin bringing all this up with guys. I'd really appreciate any information or advice. Thank you!

JsGrl38 · August 2006

Hi there. I also had papillary carcinoma and am concerned myself with fertility. My advice would be to also talk to your OBGYN about this. My doctors weren't very informative with information either. When I talked to my OBGYN, she said that we'd discuss things once I was closer to having children. I'm recently married and feel that urge to start my family. I share in your concern and know how it feels NOT to know whether or not you're able to have children.

Rustifox · August 2006

Here are some studies and info that may be helpful to both of you.

While most doctors recommend waiting at least a full year following I-131 treatment doses before becoming pregnant, it is unlikely to be a concern for younger women. Many, many patients have gone on to have healthy, large families in your situations, and even in situations where the pregnancy occured shortly after treatments:
http://www.thyroid.org/patients/notes/july02/02_07_39.html
http://pmj.bmjjournals.com/cgi/content/full/78/916/92
Here are some further studies:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8462605

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9854681

http://www.fetal-exposure.org/thyroid.html

In older women, ie those of us in our early to mid 40's, and nearing perimenopause or menopause, it is possible to see early menopause from I-131 treatments. In addition, there has been some data showing (very) temporary ovarian failure after I-131 treatments - but this has also been shown to 'recover' with the exception of older women:
http://jcem.endojournals.org/cgi/content/abstract/69/1/186

http://jcem.endojournals.org/cgi/content/full/86/8/3512

Hopefully, these will help to set your mind at ease. It is always good advice to discuss this issue with your OBGYN and endocrinologist, of course - but studies do agree that the vast majority of women will go on to have successful pregnancies, providing your TSH is monitored at least monthly during your pregnancies.

Our TSH DOES goe wonky when pregnant, though - again, make sure that your TSH is monitored carefully, closely, and frequently whenever you do decide to begin your family - becoming hypothyroid at all when pregnant can be a major risk to the fetus. Hope it helps!

hana123 · August 2006

Rustifox said:
Here are some studies and info that may be helpful to both of you.

While most doctors recommend waiting at least a full year following I-131 treatment doses before becoming pregnant, it is unlikely to be a concern for younger women. Many, many patients have gone on to have healthy, large families in your situations, and even in situations where the pregnancy occured shortly after treatments:
http://www.thyroid.org/patients/notes/july02/02_07_39.html
http://pmj.bmjjournals.com/cgi/content/full/78/916/92
Here are some further studies:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8462605

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9854681

http://www.fetal-exposure.org/thyroid.html

In older women, ie those of us in our early to mid 40's, and nearing perimenopause or menopause, it is possible to see early menopause from I-131 treatments. In addition, there has been some data showing (very) temporary ovarian failure after I-131 treatments - but this has also been shown to 'recover' with the exception of older women:
http://jcem.endojournals.org/cgi/content/abstract/69/1/186

http://jcem.endojournals.org/cgi/content/full/86/8/3512

Hopefully, these will help to set your mind at ease. It is always good advice to discuss this issue with your OBGYN and endocrinologist, of course - but studies do agree that the vast majority of women will go on to have successful pregnancies, providing your TSH is monitored at least monthly during your pregnancies.

Our TSH DOES goe wonky when pregnant, though - again, make sure that your TSH is monitored carefully, closely, and frequently whenever you do decide to begin your family - becoming hypothyroid at all when pregnant can be a major risk to the fetus. Hope it helps!

Thanks, ladies. I feel better now that I have some resources and a place to ask questions.

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Concern over fertility

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