Mechanisms and risk assessment of cancer treatment-induced female fertility impairment / 国际肿瘤学杂志

ABSTRACT

Surgical resection,radiotherapy and chemotherapy are the current mainstays of cancer treatments.During ovarian cystectomy,part of the normal ovarian cortex could be resected together with ovarian mass,which suppresses ovarian reserve postoperatively.This reduction in ovarian reserve is especially produced after resection of ovarian endometriomas.On the other hand,radiotherapy and chemotherapy may cause cell apoptosis,diminish blood supply in the ovaries and weaken the brake on follicular recruitment.Brought together,these mechanisms give rise to accelerated deprivation of ovarian follicles,and hence undermine fecundity of the affected individuals.Moreover,radiotherapy could result in alterations in structure and functions of uterus and other pelvic organs,which translate into increased incidence of obstetric complications later on.Currently antral follicular count and serum anti-Müllerian hormone are the most sensitive and accurate measurements of ovarian reserve.