Ovarian failure in long-term survivors of childhood malignancy

Hypogonadism After Childhood Cancer Treatment

“…10) as the most important risk factor emerged GCT and in the second division pelvic RT. Similarly, other authors observed that pelvic RT is the most important risk factor for ovarian failure (Hamre et al 1987, Stillman et al 1981) observed that the only risk factor for ovarian failure in 182 long-term survivors of childhood cancer was ovarian position relative to the RT field and not ChT. Of course, ovarian failure may be caused by ChT with AA (Chapman et al 1979, Nicosia et al 1985, Ortin et al 1990, Siris et al 1976, what was observed in our study as well, namely all females with PH without receiving pelvic RT had ChT with AA.…”

“…In the study of Ortin and colleagues 2 of 18 girls were amenorrhoic after having received 6 or more cycles of MOPP (Ortin et al 1990). In our study none of the 6 females was amenorrhoic after 6 or more cycles of MOPP, but 2 had evidence of ovarian damage while retaining fertility Probably in girls younger than 16 years ChT is less gonadotoxic because relative quiescence of stromal cells and oocytes in prepubertal period protects ovaries from cell cycle specific cytotoxic agents (Siris et al 1976, Stillman et al 1981. Forty-six patients didn't receive neither testicular or pelvic RT nor ChT with AA.…”

“…Of the remaining 8 female patients with PH, one had transient, secondary amenorrhea lasting for 5 years, one is in early menopause (at 38 years of age) after 2 deliveries, 6 of them have irregular periods, 2 after 1 to 2 deliveries. Indeed, in most studies the term ovarian failure was used in patients with amenorrhea, elevated levels of gonadotropins and lower levels of estradiol (Stillman et al 1981, Chapman et al 1979). Thus, ovarian failure, defined in such a way, was diagnosed in 6 of our female patients only.…”

Gonadal function following chemotherapy for childhood Hodgkin's disease

“…Ovarian function in the prepubertal and pubertal female is less certain, with limited studies demonstrating the resilience of the ovary to chemotherapy [6,7,14,15]. Recent evidence, however, has identified a nine-fold risk of developing premature menopause after treatment with alkylating agents during adolescence, with the associated 0 1996 Wiley-Liss, Inc.…”

Spontaneous Pregnancy after 13 Years of Amenorrhea in aPatient with a Voluminous Ovarian Dysgerminoma and Submitted to Left Adnexectomy and Radiotherapy

“…Therefore post-RT sterility could have occurred. Protecting the medial margins of the left treated area and screening the right half of the pelvis during RT of the paravertebral lymph node chains resulted in an 80-90% decrease in the radiation on the right ovary, as shown by Stillman et al [9].…”