Highlights
- •Childhood cancer survivors are living longer.
- •High cumulative doses of alkylating agents and/or radiation increase the risk of premature ovarian insufficiency.
- •Ovarian function monitoring after therapy is dependent on pubertal status.
- •A risk of premature ovarian insufficiency should prompt referral to a reproductive endocrinology specialist.
Abstract
Most children diagnosed with cancer survive for many years after treatment. However,
the fertility potential of these patients may suffer due to their oncologic therapies.
Certain chemotherapies and radiation are more likely to be detrimental to gonadal
function, and put patients at risk of acute or premature ovarian failure. Prepubertal
cancer patients will need different follow-up and testing from their post-pubertal
counterparts. This review will present evidence to help patients, family members and
physicians determine who is most at risk of ovarian insufficiency and how to monitor
childhood cancer survivors. It will discuss the impact of age at diagnosis and cancer
therapies on reproductive outcomes, and guide caregivers and patients on monitoring
gonadal function after therapy.
Keywords
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References
- Fertility of female survivors of childhood cancer: a report from the childhood cancer survivor study.J. Clin. Oncol. 2009; 27: 2677-2685
- A pilot study about female adolescent/young childhood cancer survivors’ knowledge about reproductive health and their views about consultation with a fertility specialist.Palliat. Support. Care. 2015; 13: 1251-1260
- SEER Cancer Statistics Review.National Cancer Institute, Bethesda, Maryland2018
- Acute ovarian failure in the childhood cancer survivor study.J. Clin. Endocrinol. Metab. 2006; 91: 1723-1728
- Ovarian aging, follicular depletion, and steroidogenesis.Exp. Gerontol. 1994; 29: 265-274
- Study design and cohort characteristics of the childhood cancer survivor Study: a multi-institutional collaborative project.Med. Pediatr. Oncol. 2002; 38: 229-239
- Pregnancy after chemotherapy in male and female survivors of childhood cancer treated between 1970 and 1999: a report from the childhood cancer survivor study cohort.Lancet Oncol. 2016; 17: 567-576
- Premature menopause in survivors of childhood cancer: a report from the childhood cancer survivor study.J. Natl. Cancer Inst. 2006; 98: 890-896
- The cyclophosphamide equivalent dose as an approach for quantifying alkylating agent exposure: a report from the childhood cancer survivor study.Pediatr. Blood Cancer. 2014; 61: 53-67
D.W. Kufe, R.E. Pollock, R.R. Weichselbaum, et al., editors. Alkylating Agents. Hamilton (ON): BC Decker; 2003.
- Anti-Mullerian hormone screening to assess ovarian reserve among female survivors of childhood cancer.J. Cancer Surviv. 2014; 8: 548-554
- Combating radiation therapy-induced damage to the ovarian environment.Future Oncol. 2016; 12: 1687-1690
- Fertility preservation in women.N. Engl. J. Med. 2017; 377: 1657-1665
- Fertility preservation and reproduction in patients facing gonadotoxic therapies: a committee opinion.Fertil. Steril. 2013; 100: 1224-1231
- Gonadotropin-releasing hormone agonists for ovarian function preservation in premenopausal women undergoing chemotherapy for early-stage breast cancer: a systematic review and meta-analysis.JAMA Oncol. 2016; 2: 65-73
- Protecting ovaries during chemotherapy through gonad suppression: a systematic review and meta-analysis.Obstet. Gynecol. 2015; 126: 187-195
- Female reproductive health after childhood, adolescent, and young adult cancers: guidelines for the assessment and management of female reproductive complications.J. Clin. Oncol. 2013; 31: 1239-1247
- Recommendations for premature ovarian insufficiency surveillance for female survivors of childhood, adolescent, and young adult cancer: a report from the international late effects of childhood cancer guideline harmonization group in collaboration with the PanCareSurFup consortium.J. Clin. Oncol. 2016; 34: 3440-3450
- Reduced ovarian function in long-term survivors of radiation- and chemotherapy-treated childhood cancer.J. Clin. Endocrinol. Metab. 2003; 88: 5307-5314
- A 10-year follow up of reproductive function in women treated for childhood cancer.Reprod. Biomed. Online. 2013; 27: 192-200
- Longitudinal follow-up in female childhood cancer survivors: no signs of accelerated ovarian function loss.Hum. Reprod. 2017; 32: 193-200
- Menses resumption after cancer treatment-induced amenorrhea occurs early or not at all.Fertil. Steril. 2016; 105 (e4): 765-772
- A comparison of live birth rates and perinatal outcomes between cryopreserved oocytes and cryopreserved embryos.J. Assist. Reprod. Genet. 2017; 34: 1359-1366
Article info
Publication history
Published online: January 23, 2019
Accepted:
January 22,
2019
Received in revised form:
January 14,
2019
Received:
December 11,
2018
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
