Cyclophosphamide-Induced Ovarian Failure

Twenty-two women receiving cyclophosphamide for either progressive glomerulonephritis (20) or rheumatoid arthritis (two) were studied to define more closely the nature of menstrual abnormalities known to occur with this drug. The patients were studied by assay of urinary estrogens and total gonadotrophins and, when possible, by ovarian biopsy. Seventeen patients had definite or probable ovarian failure after cyclophosphamide. No patient on whom ovarian biopsy was performed showed normal follicular maturation, and ova were seen in only two. One patient judged clinically and biochemically to have ovarian failure regained normal ovarian function 10 months after cessation of cyclophosphamide therapy. (N Engl J Med 289:1159–1162, 1973)