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BSO Fertility Menopause — SCE Medical Oncology MCQ

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EasyGynaecological CancersBSO Fertility MenopauseSCE Medical Oncology

A 50-year-old woman with ovarian cancer is being counselled about family planning after completing treatment. She had bilateral salpingo-oophorectomy. What are the implications?

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Correct answer: A — Bilateral oophorectomy = permanent infertility and premature surgical menopause — HRT should be offered until natural menopause age (~51) unless contraindicated (e.g. ER+ breast cancer history); oocyte/embryo cryopreservation should have been discussed before surgery in women of reproductive age

BSO for ovarian cancer: permanent infertility + surgical menopause. For young women: pre-operative fertility preservation discussion mandatory (NICE CG156). HRT until age ~51 (unless contraindicated): vasomotor symptoms, bone protection, cardiovascular health. Premature menopause without HRT increases cardiovascular, osteoporosis and cognitive decline risk.

Reference: NICE CG156 Fertility; ESMO 2024 Survivorship; BMS Menopause Guidelines