Breast cancer treatment and ovarian function

Oncofertility as an Essential Part of Comprehensive Cancer Treatment in Patients of Reproductive Age, Adolescents and Children

“…It has a fairly stable concentration throughout the whole menstrual cycle apart from a slight decrease in its level at the end of the follicular phase; hence, its value can be measured irrespective of the day of the cycle. AMH is secreted by the granulosa cells of growing follicles, mainly preantral and early antral follicles, and thus can be used to evaluate the functional ovarian reserve [22,27,28]. Despite being a good predictor of the number of follicles that can potentially ovulate, AMH does not inform about their quality or real chance of becoming pregnant or pregnancy progression [22].…”

“…Regarding their effects on the ovaries, they primarily cause growth inhibition and atresia in the pool of growing preantral and antral follicles, without reducing the number of primordial follicles (Table 2) [55]. Rapidly dividing granulosa cells in preantral and antral follicles have a high metabolic demand and hence are more sensitive to the effects of antimetabolites, which explains their selective atresia [27,44].…”

“…Taxanes are a group of drugs that inhibit the function of the division spindle by binding to tubulin and stabilising microtubules. In addition, these drugs induce the apoptosis of cells by inducing their return to the G phase of the cell cycle [27]. Much controversy revolved around the specific gonadotoxicity of taxanes due to the fact that they were usually used in combination or sequential therapies [56].…”

“…Much controversy revolved around the specific gonadotoxicity of taxanes due to the fact that they were usually used in combination or sequential therapies [56]. Initial reports did not indicate harmful effects of their use, but later studies confirmed their gonadotoxicity involving the induction of ovarian growing follicle atresia by the inhibition of the function of division spindles during meiotic division I and II, leading to endocrine disruption, amenorrhoea and reduced ovarian reserve (Table 2) [27,[56][57][58][59].…”

The Role of Cyclin-Dependent Kinases (CDK) 4/6 in the Ovarian Tissue and the Possible Effects of Their Exogenous Inhibition

“…Indeed, several studies have demonstrated the risks and mechanisms of chemotherapyinduced ovarian damage. Chemotherapy agents can induce both structural and functional damage [4]; there is evidence of follicle destruction, characterized by the apoptotic death of oocyte and somatic cells [5,6], as well as vascular damage [7,8] and the premature activation and atresia of primordial follicles [9]. However, limited data are currently available on the use of other newer anticancer therapies including targeted agents.…”