Molecular Mechanism and Prevention Strategy of Chemotherapy- and Radiotherapy-Induced Ovarian Damage

Int J Mol Sci. 2021 Jul 13;22(14):7484. doi: 10.3390/ijms22147484.

Abstract

Fertility preservation is an emerging discipline, which is of substantial clinical value in the care of young patients with cancer. Chemotherapy and radiation may induce ovarian damage in prepubertal girls and young women. Although many studies have explored the mechanisms implicated in ovarian toxicity during cancer treatment, its molecular pathophysiology is not fully understood. Chemotherapy may accelerate follicular apoptosis and follicle reservoir utilization and damage the ovarian stroma via multiple molecular reactions. Oxidative stress and the radiosensitivity of oocytes are the main causes of gonadal damage after radiation treatment. Fertility preservation options can be differentiated by patient age, desire for conception, treatment regimen, socioeconomic status, and treatment duration. This review will help highlight the importance of multidisciplinary oncofertility strategies for providing high-quality care to young female cancer patients.

Keywords: chemotherapy; embryo cryopreservation; fertility preservation; gonadotoxicity; oncofertility; oocyte cryopreservation; oocyte in vitro maturation; ovarian suppression; ovarian tissue cryopreservation; radiotherapy.

Publication types

  • Review

MeSH terms

  • Cryopreservation / methods*
  • Drug Therapy / statistics & numerical data*
  • Female
  • Fertility Preservation / methods*
  • Humans
  • Neoplasms / complications*
  • Neoplasms / drug therapy
  • Neoplasms / radiotherapy
  • Ovary / physiology*
  • Primary Ovarian Insufficiency / etiology
  • Primary Ovarian Insufficiency / pathology
  • Primary Ovarian Insufficiency / prevention & control*
  • Radiotherapy / adverse effects*