Return of fertility after autologous stem cell transplantation

Objective: To study cases where bone marrow transplantation (BMT) or peripheral blood stem cell transplantation (PBSCT)-induced menopause was entirely reversed. Design: Retrospective analysis. Setting: An inpatient BMT unit and an ambulatory fertility center in a university hospital. Patient(s): Two patients with Hodgkin's disease and two with advanced breast carcinoma requiring stem cell transplantation. Intervention(s): Estrogen treatment, monitoring of follicle-stimulating hormone (FSH) and estradiol (E₂) levels, and, ultimately, monitoring of pregnancy. Main Outcome Measure(s): Pregnancy. Result(s): All four patients established pregnancies, but two of them elected to terminate due to the use of tamoxifen early in pregnancy. Conclusion(s): Menopausal changes resulting from BMT may spontaneously reverse, with reestablishment of normal hormonal function and viable pregnancies.