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Skbr's avatar
Skbr
Member
4 years ago

Zoladex immediately after IVF

Hi ladies, I was wondering if anyone has had their Zoladex injection straight after an IVF cycle? My lymph nodes were clear so I don’t need chemo, but my oncologist wants to put me on Zoladex & Aromasin for 5 years, (with a break after 2y to have children - I’ll be 38/39). 

I am almost through an IVF round to freeze my eggs & was wondering if it’s healthy or safe for your ovaries to be hyper stimulated & then shutdown immediately afterwards. Or is it better to wait a few days/week for them to return to normal before starting Zoladex? 

None of my specialists seem to be communicating with each other, so I’m finding it difficult to know the urgency or safety around the issue. I don’t want to damage my fertility for the future, or increase my recurrence chances..

Would really appreciate any advice!

*** A bit of background on my cancer:
I’m 36 & I have Hormone positive (80%), HER2 negative breast cancer, ki67 16% (3 tumours in the right breast). 

I had a single nipple & skin sparing mastectomy with an expander (in preparation for radiotherapy), 10.5weeks ago. My breast surgeon got clear boarders and tested 4 lymphnodes which were also clear, so seemed to think I would need no further treatment, (which I found unusual for early bc). 

My surgeon then took 3 weeks to seek a multidisciplinary meeting with an oncologist & radiation oncologist, after which she said I’d need endocrine therapy to be safe, but no longer need radiotherapy. It took 8 weeks after surgery to get an oncologist appointment - and now I am starting IVF, then endocrine therapy next week. It’s been very difficult waiting around, without being given much information. (Perhaps I’ll post another question, asking if such slow, conservative aftercare is normal!)


family
hormone-therapy
new-diagnosis
tamoxifen
young-women

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  • JaneinMelbourne's avatar
    JaneinMelbourne
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    4 years ago
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    Hi @skbr 

    I had a break between my IVF cycles (I did 2 back to back in between surgeries) and starting zoladex but this was more so due to waiting for additional testing to come back to understand the benefit of chemotherapy before commencing treatment. Your specialists should definitely be communicating with each other, did your oncologist refer you to the IVF specialist? 
    I found the effects of zoladex very harsh on my body so I appreciate your concern about going from one extreme to the other (I only lasted on it for my chemo treatment before switching off) You should definitely ask whether you can take a break between the two - my scientific knowledge is pretty limited but shutting down the ovaries hit me quite hard with lots of menopausal systems (I was 33) and you might experience the same. My oncologists were always quite comfortable with me having 2 weeks off in between treatments / ie chemo to radio to starting tamoxifen.
    Sorry to hear you are not getting the information you need, it makes everything a lot harder I’m sure xx 
  • Skbr's avatar
    Skbr
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    4 years ago
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    Hi @JaneinMelbourne, thanks so much for your response. 
    My oncologist didn’t refer me to anyone in particular. My GP actually referred me an IVF doctor, but I don’t think they has much experience in treating women with hormone positive cancer. 
    (Both the oncologist & IVF doctor told me not to bother taking letrozole during my egg stimulation cycle - but after doing more reading I discovered that using letrozole to stabilise oestrogen spikes during egg stimulation is standard for hormone positive oncofertility patients. So I’m a bit worried now!) I might need to find a new Oncologist 😬

    Could I ask what type of hormone therapy you are on & for how long? Is it usually Tamoxifen for 2 years and then a pause for children?

  • JaneinMelbourne's avatar
    JaneinMelbourne
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    4 years ago
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    Wow really - I’m sorry to hear that, thinking back it was actually my surgeon who made the recommendation to the IVF specialist. I took tamoxifen during the first cycle but not the second. 
    Yes absolutely, so my husband and I had been trying for a baby when I was diagnosed last September, and initially we were told 2 years to wait. My risk of recurrence is fairly low after doing chemo and radiation (I did the prosigna test) - so pending I get the all clear from my imaging in September my IVF specialist and my oncologist have agreed that I can start IVF then. At the moment I’m on tamoxifen and will continue up until August then go on a break. We decided to skip straight to IVF rather than trying naturally to minimize time off the medication, hopefully will lead to a pregnancy faster 🤞🤞🤞
    then back on the tamoxifen again! 
    Hope that helps xx