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Fertility after radioactive iodine therapy in thyroid cancer patients

Background:  For patients with differentiated thyroid carcinoma (DTC), the effect of radioactive iodine (RAI) therapy on gonadal and reproductive function is an important consideration.

Objective and Methods: 127 children were operated on thyroid in case of DTC during 1975-2015. 87 pts were treated by RAI (1-13 times).  Average age is 15 years (4-18).  Histological types of DTC were papillary (69%), follicular (27%) and other (4%). Average follow up period is 3 year (2-40). We analyzed effect of therapeutic RAI on sex steroid level; on ovarian function, menses, ovulation in women; sperm in men; future fertility; pregnancy outcomes.

Results: Early side effects (during 1st week after RAI) includednausea and vomiting (29%), sialoadenitis (22%), temporal bone marrow dysfunction (6%).  Late side effects included permanent salivary glands’ dysfunction (2%), permanent bone marrow dysfunction (4%), lung fibrosis (5%), second tumors – leucosis, breast cancer (4%), and fertility disorder (7%). Fertility was analyzed in 78 pts. Sterility (2%), amenorrhea (4%), changes in menstrual period (5%), miscarriage (4%).

Conclusion: RAI should be prescribed only for indications. Sexual cell should be cryopreserve before RAI.

Author(s): Kristina Vabalayte and Anatoly Romanchishen

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