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Chapter 2 - The Effect of Chemotherapy on the Human Reproductive System

from Section 1 - Introduction

Published online by Cambridge University Press:  27 March 2021

By
Hadassa Roness  and
Dror Meirow
Edited by
Jacques Donnez  and
S. Samuel Kim
Jacques Donnez
Affiliation:
Catholic University of Louvain, Brussels
S. Samuel Kim
Affiliation:
University of Kansas School of Medicine
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Summary

Chemotherapy induces ovarian damage in a drug- and dose-dependent manner, and is related to age at the time of treatment, with progressively smaller doses required to produce ovarian failure with increasing age [1, 2].

The stockpile of primordial follicles found in the cortex of the ovaries represents the ovarian reserve. Histological studies of human ovaries have shown chemotherapy to cause ovarian atrophy and global loss of primordial follicles [3, 4]. A reduced follicular reserve may result in premature ovarian failure (POF) and menopause many years posttreatment, even in patients undergoing chemotherapy at a very young age [5]. The odds ratio of POF is as high as 3.8 in childhood cancer survivors of Hodgkin’s disease and 3.2 for non-Hodgkin’s lymphoma [6]. In addition, women who do not undergo POF and retain ovarian functionality after chemotherapy may still have reduced fertility.

Type
Chapter
Information
Fertility Preservation
Principles and Practice
 , pp. 11 - 17
Publisher: Cambridge University Press
Print publication year: 2021

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