Chemotherapy-induced ovarian damage and protective strategies

Hum Fertil (Camb). 2023 Oct;26(4):887-900. doi: 10.1080/14647273.2023.2275764. Epub 2023 Dec 17.


More than 9.2 million women worldwide suffer from cancer, and about 5% of them are at reproductive age. Chemotherapy-induced impairment of fertility affects the quality of life of these women. Several chemotherapeutic agents have been proven to cause apoptosis and autophagy by inducing DNA damage and cellular stress. Injuries to the ovarian stroma and micro-vessel network are also considered as pivotal factors resulting in ovarian dysfunction induced by chemotherapeutic agents. Primordial follicle pool over-activation may also be the mechanism inducing damage to the ovarian reserve. Although many studies have explored the mechanisms involved in chemotherapy-induced reproductive toxicity, the exact molecular mechanisms have not been elucidated. It is essential to understand the mechanisms involved in ovarian damage, in order to develop potential protective treatments to preserve fertility. In this article, we reviewed the current knowledge on the mechanism of chemotherapy-induced ovarian damage and possible protective strategies that prevent the ovary from such damages.

Keywords: Chemotherapy; cancer; infertility; ovarian damage; ovarian protection.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents* / adverse effects
  • Female
  • Fertility / physiology
  • Humans
  • Ovarian Follicle
  • Ovarian Reserve*
  • Ovary / physiology
  • Quality of Life


  • Antineoplastic Agents