Can't decide on ovaries...help

Hi, Im scheduled for a subtotal abdominal hysterectomy on July 6th and still haven't decided if I will have my ovaries removed. I have read Gilda Radners book, visited the American Cancer Society web page, and now I would love to hear some of your experiences.

I am 44 years old and have a beautiful 23 year old daughter who made me a grandma 6 months ago. There is no history of cancer in my family. Seven years ago we tried for a second child and I took Clomid for 2 months in '93 and 7 months in '94. In '96 I took Pergonal for 1 month and had the GIFT procedure. I did not get pregnant.

If I had not taken the infertility drugs, I would definitely keep my ovaries. Women in my family do not go through menopause until 53-54. Our family history is problems with the heart and strokes. My sister just went through menopause and cannot tolerate HRT. She gets severe migraines. I could not tolerate the pill, due to headaches. I understand there are some natural alternatives, but I think they include soy, which I sometimes have an allergic reaction to.

I am afraid to give up my ovaries in case I can't tolerate HRT. At my age that would not be good with my family heart history. On the other hand I am afraid I shortened my life span with the infertility drugs.

Any words of wisdom or experiences will be greatly appreciated.

Thanks,
Dee - 7/6/00


[Edited by Moreci on 06-24-2000]

It's a gamble either way. And you're just young enough it makes a difference. I don't know about the risk profile from the infertility drugs, but I do know that ovarian cancer is quite rare. The problem is with the detection. Intravaginal ultrasound catches some (caught mine), the blood test reveals quite a few, palpation catches others, otherwise the warning signs are subtle. But in the ordinary scheme of things, it is rare.

While reactions to HRT are very individual, the soy allergy is a bit worrisome. While the pharmeceutical companies do not issue allergy warnings, and they are high synthesized, still you got to wonder. Some are from wild yams, not soy, but the trick is finding out which ones. I'm ethically against Premarin, but it's obviously not a soy product. A lot of us find that adding a small amount of bio-identical progesterone balances the estrogen replacement and relieves the migraines.

Hormonal balance is a subtle dance between lots of systems in the body and the adrenal glands can kick in and do a lot for you. I guess this isn't too helpful. But, if you don't already have cancer that you're dealing with, or some other estrogen problem (like endo), I would tend to keep them at 44--with a watchful eye. That's 10 years of bone and heart protection.

Have you spoken to your doctor about the risks of keeping your ovaries. It sounds like you will need them for another 10 years. Find out the risks that the fertility drugs may have put you in. If you are allergic to soy and your sister is having problems with HRT, then I have to wonder if keeping your ovaries and going the natural route wouldn't be best. The very best thing that you could do is talk to your doctor, research the allergic reactions in your family, and you got it...wait for more responses here. What ever you decide, you must think things through and make sure that the decision is really yours. Good luck, we will be thinking of you! Please let us know what you finally decide.

I had a TAH/BSO on June 14. Three months ago when I went in for my ultrasound, my doctor noticed a cyst on my right ovary--prior to this the left one only looked like the unhealthy one.The laproscopy I had last fall revealed that the right ovary was perfectly healthy. The ultrasound got me thinking (and I panicked and got scared) about removing everything. I am 46. After emotionally processing the idea of having everything removed, I suggested to my doctor during my pre-op, why not take everything??? I guess between 45-50 it is case by case "call" to make. After 50 most doctors in our area will just take them. It was a good feeling as I felt somewhat "empowered" by making that choice. By the time surgery came around I was ready. Once she (my doc) got in there, she had discovered that my right ovary was starting to disease as well. Things deteriorated that quickly. Fortunately, no cancer. But I knew I didn't want to go through surgery again.

I didn't realize I would go into much detail. But I know what a tough decision you are faced with and the emotions experienced. I felt so thankful and relieved after the surgery was done and reviewing the pathology report with my doctor.

I pray that you feel at peace with whatever choice you make.

Laura
TAH/BSO
6/14/00

Thanks for your responses which help me look at things from different perspectives. I called the American Cancer Society and they directed me to some articles published in the New England Journal of Medicine on Ovarian Cancer and Infertility Drugs. They also put me in touch with the pharmaceutical company that makes Clomid. They are sending me drug information and more studies. Now I need to read and apply it to my situation.

I'll share what I learn from the articles and will check in with my Hyster Sisters daily to see if there is anything new. You will hear from me again soon. Thanks! I just can't say thanks enough.

Dee