extreme situation (ovarian cancer ment'd)

extreme situation (ovarian cancer ment'd)

Joined: August 4th, 2011, 8:18 pm

March 17th, 2012, 4:17 pm #1

I have an acquaintance on another board who has been doing fertility treatments for a number of years. She said that when she enters menopause, she is going to electively remove her ovaries. Does this seem extreme to you? I know I have discussed the fertility meds and risks with Dr. Ch.eck but he felt doing ultrasounds every few months once I am done with fertility treatment should be enough. He also thought with low stim, there really wasn't any harm. He felt that the high FSH wasn't a concern or taking FSH meds, since women in menopause have high FSH to begin with, and they are not removing their ovaries. His main concern is if you were to be on protocols that continuously raise your estrogen levels, then that wouldn't be a good thing. I asked my DH what he thought about the removal of ovaries, and it seemed like he thought it wasn't a bad idea. Not that he was suggesting I do it, but that it would definitely decrease any risk at all. He said that at menopause, your ovaries are not going to be of any use, so as a preventive measure, he didn't see anything wrong with it. What do you think - is it something that we should consider if we have done multiple fertility treatments?
Last edited by alima1 on March 17th, 2012, 4:51 pm, edited 1 time in total.
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ekb88
ekb88

March 17th, 2012, 6:38 pm #2

Of ovarian or breast cancer? I lost my mom to ovarian cancer when she was just 54. She was initially diagnosed at 49 and given 6 months to live. She survived so long on sheer will. I have honestly always planned to have my ovaries removed when I was done having kids. I just had no idea it would take me so long to have them!!

The problem with oc is that there is no good method of early detection. Even for me, with a family history, the best I can get are u/s and the CA 125 test, which is not a reliable test at all. Yale developed a test that looks at multiple blood markers, but it seems to be held up in the approval stage so it is not yet available. Very frustrating for those of us at known high risk.

I will get my last ovary out at 45 probably (one already removed due to endo cyst). But I would have done that without IVF in my history.
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Joined: August 4th, 2011, 8:18 pm

March 17th, 2012, 6:56 pm #3

I didn't think she had a family history, I think she was just scared of all the meds and the potential risk. So, in your case since you have a family history, it makes sense. I don't know - I guess it is something to consider for the rest of us. I mean we don't really know the effects of all these meds, and after menopause, your ovaries are of no use. So, why take the risk. Maybe get them removed and then it gives you peace of mind. I do know that I am the type that would worry down the road about whether I have done harm to myself with my treatments. So, maybe in this situation, I should think about it. Who do you go to for this removal, is it a general ob-gyn?
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Joined: December 20th, 2010, 7:38 pm

March 18th, 2012, 4:28 am #4

I have an acquaintance on another board who has been doing fertility treatments for a number of years. She said that when she enters menopause, she is going to electively remove her ovaries. Does this seem extreme to you? I know I have discussed the fertility meds and risks with Dr. Ch.eck but he felt doing ultrasounds every few months once I am done with fertility treatment should be enough. He also thought with low stim, there really wasn't any harm. He felt that the high FSH wasn't a concern or taking FSH meds, since women in menopause have high FSH to begin with, and they are not removing their ovaries. His main concern is if you were to be on protocols that continuously raise your estrogen levels, then that wouldn't be a good thing. I asked my DH what he thought about the removal of ovaries, and it seemed like he thought it wasn't a bad idea. Not that he was suggesting I do it, but that it would definitely decrease any risk at all. He said that at menopause, your ovaries are not going to be of any use, so as a preventive measure, he didn't see anything wrong with it. What do you think - is it something that we should consider if we have done multiple fertility treatments?
this is my plan. After I am done with banking, I will electively remove my ovaries even if it brings on onset of menopause earlier than natural.

I talked about this with my oncologist extensively, and he doesn't think it is too extreme of a solution if I am going on years of fertility treatment. He just finished a big scale early detection study when I had this conversation. We all know CA125 is useless, but his study shows that even regular ultrasound scan for women with a family history of ovarian cancer (a known high risk group) yield too many false negatives to be deemed a reliable detection method.

You can get it done by obgyn.

Now, here is a less aggressive method suggested by my obgyn. Studies have shown that most, not all, ovarian cancer cases originate from the fallopian tubes. So when I was doing hysterectomy, my obgyn offered to take out my fallopian tubes, but my RE insisted on having them intact to ensure least disruption to ovary blood flow. My obgyn said instead of taking out ovaries, I can just take out the fallopian tubes.

Alternatively, my oncologist also suggests taking out the ovaries around 50. I should take them out as close to natural menopause as possible. Study shows that incidence of ovary cancer increases the most when one hits 50-60. That way, you don't need to bring on menopause prematurely, nor do you need to worry about ovarian cancer.
Last edited by miraclex2 on March 18th, 2012, 4:29 am, edited 1 time in total.
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Joined: August 4th, 2011, 8:18 pm

March 18th, 2012, 3:23 pm #5

I wasn't speaking of you - LOL, but it is interesting that you are also thinking of this. I don't have a history of ovarian cancer in my family, but I do have an incidence of breast cancer in my family. Once I end my fertility treatment and get closer to 50, I may research into doing this. I didn't realize that most ovarian cancer begins in the tubes. So, for those that had to remove their tubes but continued fertility treatment, they would actually have a lower risk for ovarian cancer? What about the uterus? If you are removing your ovaries, should you also just have the uterus removed (just to be on the safe side)? I know you had them removed but in general, if someone is electively considering to remove their ovaries, should they also consider removing the uterus as well?
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Joined: December 20th, 2010, 7:38 pm

March 18th, 2012, 5:00 pm #6

that is what you should be looking for if you are afraid of cancer risk.

Here is the priority list:

Ovarian cancer is the silent killer, and most of the incidences cannot be detected till very late. First to go.

Uterine cancer develops more slowly, and can be detected by ultrasound scan as well as biopsy (without D&C, can only catch 80%).

Cervical cancer the easiest to catch through pap smear and colposcopy and easily cured at early stage. However, it is a major conduit for uterine cancer to spread.

If you are going to take out ovaries anyway, might as well go for total hysterectomy - ovaries, follopian tubes, uterus and cervix. If you are near menopause or past menopause, all these organs have no use for you and they only represent downside. I took out cervix this time as well, and it doesn't affect the quality of sex life at all, just as what my obgyn told me.

If you want a less radical solution, take out ovaries + fallopian tubes, and then monitor uterus and cervix.
Last edited by miraclex2 on March 18th, 2012, 5:48 pm, edited 1 time in total.
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Ariadne
Ariadne

March 19th, 2012, 2:27 am #7

I have an acquaintance on another board who has been doing fertility treatments for a number of years. She said that when she enters menopause, she is going to electively remove her ovaries. Does this seem extreme to you? I know I have discussed the fertility meds and risks with Dr. Ch.eck but he felt doing ultrasounds every few months once I am done with fertility treatment should be enough. He also thought with low stim, there really wasn't any harm. He felt that the high FSH wasn't a concern or taking FSH meds, since women in menopause have high FSH to begin with, and they are not removing their ovaries. His main concern is if you were to be on protocols that continuously raise your estrogen levels, then that wouldn't be a good thing. I asked my DH what he thought about the removal of ovaries, and it seemed like he thought it wasn't a bad idea. Not that he was suggesting I do it, but that it would definitely decrease any risk at all. He said that at menopause, your ovaries are not going to be of any use, so as a preventive measure, he didn't see anything wrong with it. What do you think - is it something that we should consider if we have done multiple fertility treatments?
I am not currently considering it, but as someone currently assisting a dear friend battling ovarian cancer, I won't say it's too extreme. The problem with ovarian cancer is that it's not easily detectable early & once it's usually detected, it's very deadly. So is it an overreaction? While not considering it myself, I can't judge it as so given what I'm living through my friend.
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Joined: September 22nd, 2009, 7:19 pm

March 19th, 2012, 1:45 pm #8

I didn't think she had a family history, I think she was just scared of all the meds and the potential risk. So, in your case since you have a family history, it makes sense. I don't know - I guess it is something to consider for the rest of us. I mean we don't really know the effects of all these meds, and after menopause, your ovaries are of no use. So, why take the risk. Maybe get them removed and then it gives you peace of mind. I do know that I am the type that would worry down the road about whether I have done harm to myself with my treatments. So, maybe in this situation, I should think about it. Who do you go to for this removal, is it a general ob-gyn?
was done by a gynecological oncologist, and that's probably who I would use again. He visually inspected for signs of cancer, and also did a wash of the abdominal cavity, and that fluid was checked for cancer cells and was clear. I've been blessed with a child over 40, and during my c-section the ob did a close inspection of the ovary and cavity. I was awake for the surgery so he was reminded to look for it a gazillion times. I've been blessed with a second pg at 43, and will have this doc do the same. I am very aware that I'm only a few years out from my mother's age at diagnosis.
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bbtocudl
bbtocudl

March 19th, 2012, 7:31 pm #9

I am not currently considering it, but as someone currently assisting a dear friend battling ovarian cancer, I won't say it's too extreme. The problem with ovarian cancer is that it's not easily detectable early & once it's usually detected, it's very deadly. So is it an overreaction? While not considering it myself, I can't judge it as so given what I'm living through my friend.
Did your friend have IVF? How old is she? This scares me quite a bit as you have said its hard to detect.
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Ariadne
Ariadne

March 19th, 2012, 8:49 pm #10

She was 41 when dx. No known family history, but she subsequently learned she carries the BRCA2 gene.
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