The effect of cancer treatment on female fertility and strategies for preserving fertility

Eur J Obstet Gynecol Reprod Biol. 2007 Feb;130(2):148-55. doi: 10.1016/j.ejogrb.2006.08.006. Epub 2006 Sep 15.

Abstract

Aggressive chemotherapy and radiotherapy in young patients with cancer has greatly enhanced the life expectancy of these patients, but these treatments often cause infertility because of the massive destruction of the ovarian reserve resulting in premature ovarian failure (POF). This review focuses on the effect of cancer treatments on fertility and on the various surgical and assisted-reproduction innovations that are available to provide the patient with the option of future pregnancies. As the emerging discipline of fertility preservation is steadily attracting increasing interest, developments in the near future promise to be very exciting. However, in everyday routine work, better interdisciplinary cooperation between gynecological and pediatric oncologists, surgeons, immunologists and endocrinologists is necessary so that individualized options for fertility preservation can be offered in advance of surgical procedures or cancer treatments. GnRH analog treatment can preserve fertility in some patients, but not in all. At present, cryopreservation of ovarian tissue appears as a very promising method of providing the cancer patient with a realistic chance of preserving fertility-a prospect that is also extremely important to patients for psychological reasons.

Publication types

  • Review

MeSH terms

  • Adult
  • Antineoplastic Agents / adverse effects
  • Cryopreservation
  • Female
  • Fertility / drug effects
  • Fertility / radiation effects
  • Gonadotropin-Releasing Hormone / analogs & derivatives
  • Gonadotropin-Releasing Hormone / therapeutic use
  • Humans
  • Infertility, Female / etiology*
  • Infertility, Female / prevention & control*
  • Infertility, Female / therapy
  • Neoplasms / therapy
  • Oocytes
  • Ovary
  • Primary Ovarian Insufficiency / chemically induced
  • Radiation Injuries
  • Reproductive Techniques, Assisted*

Substances

  • Antineoplastic Agents
  • Gonadotropin-Releasing Hormone