Chemotherapy Associated Ovarian Failure

Abstract

As the incidence of malignancies in young adults is increasing, fertility preservation in cancer survivors arises as a major concern. Especially among female cancer patients, pregnancy rates are estimated to be 40% lower compared to women of the same age. Nowadays oncologists are to be preoccupied not only with their patients’ successful treatment, but also with the maintenance of the potential of the latter to conceive and obtain children. Chemotherapy associated ovarian failure (COF), refers to disruption of ovarian function both as an endocrine gland and as a reproductive organ, due to previous exposure to chemotherapy agents. Although the underlying mechanism is not fully understood, it is supposed that chemotherapy agents may induce either DNA damage of premature ovarian follicle or early activation and apoptosis of them, resulting into early exhaustion of available follicle deposit. Various chemotherapy agents have been associated with COF with the highest incidence being reported for patients undergoing combination regimens. Although a variety of alternatives in order to maintain ovarian function and fertility in female cancer survivors are available, adequately established practices to do so are lacking. Thus, it is of major importance to investigate further and collect sufficient evidence, aiming to guide patients and physicians in everyday clinical practice.

Fatigue and endocrine symptoms among women with early breast cancer randomized to endocrine versus chemoendocrine therapy: Results from the TAILORx patient‐reported outcomes substudy

“…Chemotherapy may also produce endocrine symptoms by inducing transient or persistent ovarian failure in premenopausal patients. 35 Similarly, tamoxifen and aromatase inhibitor (AI) side effects 36 differ by menopausal status. 37 TAILORx allowed an examination of the unique contribution of chemotherapy to fatigue and endocrine symptoms as well as symptom trajectories extending into Abbreviations: CT+E, chemotherapy followed by endocrine therapy; E, endocrine therapy.…”

The Effect of Chemotherapy on Estradiol Levels in Patients with HER 2-Overexpression Breast Cancer in Dr Moewardi General Hospital, Surakarta, Indonesia

“…Giving free anthracite base chemotherapy can reduce E1, E2, and FSH levels. These hormones initiate the proliferation and invasion of cancer cells by activating the oncogene enzyme protein, thereby increasing cancer growth [20], [21], [22], [23].…”

Cancer therapy's impact on lipid metabolism: Mechanisms and future avenues

“…However, in a study of patients on cyclophosphamide, methotrexate and 5-FU with premature ovarian failure, risk of dyslipidemia was significantly increased ( 122 ). Chemotherapy regimens with a high risk for ovarian failure include those with cyclophosphamide, methotrexate, anthracyclines, and 5-FU for 6 or more cycles, especially in patients age > 40 years ( 123 ). SERMs may offer protection against the dyslipidemia seen in CIOF.…”