Ovarian failure following abdominal irradiation in childhood: Natural history and prognosis

Wallace, W. Hamish B.; Shalet, Stephen M; Crowne, Elizabeth; Morris‐Jones, P. H.; Gattamaneni, H. R.

doi:10.1016/s0936-6555(89)80039-1

Cited by 196 publications

(108 citation statements)

References 11 publications

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“…Childhood radiotherapy increases the risk of hypothalamus and pituitary gland damages and results in decreased pituitary gonadotropins subsequently leading to ovaries dysfunction [24]. Ovarian radiation results in loss of hormone production and infertility because the normal hormone level is critical for the ootid development and plays an essential role in the maturation of the primary follicle [25]. Our metaanalysis also demonstrated the significant association between AOF and radiotherapy during childhood (Fig.…”

Section: Discussionsupporting

confidence: 53%

Exposure to radiation therapy is associated with female reproductive health among childhood cancer survivors: a meta-analysis study

Gao

Liang

Qiu

2015

J Assist Reprod Genet

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Background and aims Many epidemiological studies have revealed a positive correlation between medical radiation exposure and the reproductive health in female childhood cancer survivors. However, because of variations in the samples size, such studies showed partly inconsistent conclusions. The aim of this meta-analysis was to clarify the association between radiotherapy and the risk of reproductive health impairment for female who survived from childhood cancer. Methods Fourteen cohort studies involving childhood radiotherapy were selected as the exposure of interest and the impaired reproductive health condition during the childbearing age as the outcome. Among meta-analysis of observational studies found in Pubmed and Embase from 1900 to 2014, we evaluated those relevant observational studies which surveyed the association of medical radiation and reproductive health in female childhood cancer survivors. Review Manager 5.2 and STATA 12.0 software were used to perform the metaanalysis. Study-specific estimations for each outcome were combined into a pooled relative risk (RR) with 95 % confidence interval (CI) by a meta-analytic approach.Results Based on a random-effects meta-analysis, significant association between infertility (RR=1.28, 95 % CI=1.16-1.42), acute ovarian failure (AOF) (RR=9.51, 95 % CI=5.03-17.96), low level of anti mullerian hormone (AMH) (<1 ng/mL) (RR=14.79, 95 % CI=3.36-66.64), stillbirth (RR=1.19, 95 % CI=1.02-1.39) and low birth weight (RR=2.22, 95 % CI= 1.55-3.17) were identified. Conversely, no significant results were found in abortion and congenital malformations. Conclusions To the best of our knowledge, this is the first meta-analysis assessing the effect of medical radiation on female childhood cancer survivors' reproductive capability and pregnancy outcomes. Although there were some limitations, our meta-analysis further supported that radiotherapy was a risk factor for reproductive health problems of female who survived from childhood cancer.

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Section: Discussionsupporting

confidence: 53%

Exposure to radiation therapy is associated with female reproductive health among childhood cancer survivors: a meta-analysis study

Gao

Liang

Qiu

2015

J Assist Reprod Genet

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“…Ovarian failure has been reported in 90% of patients followed long term after TBI (10-15.75 Gy) and in 97% of females treated with total abdominal irradiation (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) Gy) during childhood. 11,12 Using our knowledge and understanding of the radiosensitivity of human oocytes, it is now possible to predict the estimated sterilizing dose after any given dose of radiotherapy at any given age based on the application of the mathematical solution to our model for natural oocyte decline (Fig. 2).…”

Section: Radiation and The Hypothalamic-pituitaryovarian Axismentioning

confidence: 99%

Oncofertility and preservation of reproductive capacity in children and young adults

Wallace

2011

Cancer

169

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With increasing numbers of survivors from cancer at a young age, the issue of fertility preservation has assumed greater importance. This review describes normal ovarian and testicular function and summarizes what is known about the effect of chemotherapy and radiotherapy on the gonads and uterus. All young patients with cancer or leukemia should have their fertility prognosis discussed before the initiation of treatment. Sperm and embryo cryopreservation should be considered standard practice and be widely available for those at significant risk of infertility. For prepubertal girls, ovarian tissue cryopreservation should be considered if the risk of premature menopause is high, but for the prepubertal boy there are no established techniques in current practice. Cancer 2011;117(10 suppl):2301–10. © 2011 American Cancer Society.

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“…2,3 Studies have shown that the infertility induced by cytostatic drugs is dependent on type and dosage of the drug used, and also on the patients' age at the time of treatment. [4][5][6][7] The most common conditioning regimen used are 12-14 Gy of TBI and CY (120 mg/kg) or etoposide (VP-16, 60 mg/kg) or a combination of BU (16 mg/kg) and CY (120 mg/kg). A number of small studies conducted with adults have shown that VP-16, BU and CY, along with other cytostatic drugs, can lead to fertility impairment, depending on the dose administered.…”

Section: Introductionmentioning

confidence: 99%

Fertility after allogeneic haematopoietic stem cell transplantation in childhood and adolescence

Borgmann‐Staudt

Rendtorff

Reinmuth

et al. 2011

Bone Marrow Transplant

155

123

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Infertility is a major late effect in patients receiving haematopoietic stem cell transplantation (HSCT). The aim of this study was to determine the proportion of patients having fertility impairment after allogeneic HSCT in childhood/adolescence and to identify the potential risk factors. Treatment and fertility data of paediatric patients with malignant and non-malignant diseases treated with allogeneic HSCT between 2000 and 2005 were collected from seven European centres. Data were obtained for 138 female and 206 male patients after a median follow-up of 6 years (range 3-12). The patients' median age was 13 years (range 4-28) at the time of years at the time of the enquiry. Seven children were born to the overall group, all at term and healthy. Fertility impairment was suspected in 69% males and 83% females. Start of treatment at age X13 years was a risk factor in females (odds ratio (OR) 4.7; 95% confidence interval (CI), 1.5 to 14.9), whereas pre-pubertal therapy was a risk factor in males (OR 0.4; 95% CI, 0.2 to 0.8). The major treatment-related risk factors were BU in females (OR 47.4; 95% CI, 5.4 to 418.1) and TBI in males (OR 7.7; 95% CI, 2.3 to 25.4). In light of the significant proportion of HSCT patients reviewed with impaired fertility, fertility conservation procedures should be considered for all patients undergoing HSCT, particularly those receiving TBI or BU-based preparative regimens.

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Ovarian failure following abdominal irradiation in childhood: Natural history and prognosis

Cited by 196 publications

References 11 publications

Exposure to radiation therapy is associated with female reproductive health among childhood cancer survivors: a meta-analysis study

Exposure to radiation therapy is associated with female reproductive health among childhood cancer survivors: a meta-analysis study

Oncofertility and preservation of reproductive capacity in children and young adults

Fertility after allogeneic haematopoietic stem cell transplantation in childhood and adolescence

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