Ovarian function, fertility and reproductive lifespan in cancer patients

ABSTRACT

Introduction: The increasing survival of girls and young women after cancer has led to a rapid growth in research into assessment of ovarian function after treatment.

Areas covered: This aim of this review is to discuss normal ovarian function over time, the impact of cancer treatment on ovarian function, the assessment of ovarian reserve after treatment, and pretreatment predictors of ovarian recovery.

Expert commentary: Ovarian function damage after chemotherapy and radiotherapy will impact on fertility and reproductive lifespan, but with great variability. Age at menopause has implications for the duration of estrogen deficiency, with its own adverse health consequences. This has led to identification of the key treatment and patient factors at the time of treatment, notably age and ovarian reserve that impact on post-treatment ovarian function. However, most studies have used outcome measures such as ongoing menses, or biomarkers such as anti-mullerian hormone (AMH), with few reporting on fertility or age at menopause.

KEYWORDS:

• Anti-Mullerian hormone
• chemotherapy
• ovarian reserve
• radiotherapy
• premature ovarian insufficiency

Declaration of interest

YJ is funded by a National Health and Medical Research Council Fellowship and the Victorian Cancer Agency. RAA’s work in this field has been supported by MRC grants G1100357 and MR/N022556/1. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript was not funded.