Ovarian function and reproductive outcomes in the female survivors of childhood and adolescent cancer patients: review

Abstract

In the last 25 years, thanks to new treatment methods, a significant improvement in 5-year survival has been observed in children under 15 year with cancer diseases. This increase has led to the emergence of a new human population: childhood cancer patients who become adult. Unfortunately, children exposed to cytotoxic chemotherapy drugs (alkylating agents and anthracyclines), and radiation undergo many metabolic and endocrine problems. Gonadal (ovarian) failure, failure of reproductive function development and related sequelae have become more noticeable in recent years in children exposed to chemotherapy and/or radiotherapy. Therefore restoration of gonadal function and fertility is of growing importance in these patients. Moreover, same risks also exist in some diseases classified benign (e.g. myelodysplasia , thalassemia, as systemic lupus erythematosus), in which treatment is constituted of chemotherapy and/or radiotherapy and bone marrow transplantation. Due to early and rapid loss of follicles, Turner's syndrome and other disease groups such as galactosemia result in absolute early menopause. As seen preservation of fertility is not only restricted to cancer patients. We aimed by preparing a comprehensive up to date review to clarify readers information. We examined in detail effects of childhood cancer treatment on ovaries , ovarian germ cell dynamics and measurement of ovarian reserve tests.