Endocrine Abstracts

A 37-year-old woman presented to ED with abdominal bloating and pain. Ultrasound abdomen showed a viable single intrauterine pregnancy at 24 weeks of gestation. Patient was surprised of the diagnosis as she had longstanding premature ovarian insufficiency (POI). She had stage 3B Hodgkin’s disease (HD) diagnosed at 14 years of age when she had BEAM chemotherapy (Carmustine, Etoposide, Cytarabine and Melphalan) followed by autograft bone marrow transplant for recurrent disease four years later. She had been in remission but developed POI at the age of 20 years and had been on hormonal replacement therapy (HRT) for 15 years. She had an uncomplicated pregnancy and was induced at 40 weeks due to reduced fetal movements. She had an emergency caesarean section for fetal distress and delivered a healthy baby. HD mainly affects young adults. Although it is one of the most curable cancers, POI in premenopausal women is a serious long-term sequel of chemotherapy. The incidence of infertility is dependent on the type of chemotherapy, radiotherapy and age of the woman. It should be remembered that there is a rare possibility of ovulation occurrence. Young women embarking on treatment for cancers should be referred to fertility experts for discussion about future fertility options. Spontaneous conception in women with POI secondary to chemotherapy is rare but possible. Women who do not wish to become pregnant must be offered contraception as HRT does not offer contraception.