Chemotherapy during childhood damages ovarian reserve and can affect future fertility. However, recent large epidemiological studies showed that the detrimental impact on fertility is less severe if women seek for pregnancy at a younger age. To explain this observation, we hypothesize that the detrimental effects of previous chemotherapy on the ovarian reserve may be attenuated in young adults for two main reasons. Firstly, recent evidence showed that the amount of ovarian reserve is not a critical factor for effective natural conceptions. Provided that the residual ovarian reserve allows regular ovulatory cycles, the chances of pregnancy are similar in women with intact or reduced ovarian reserve. Secondly, ovarian reserve depletion appears to be a phenomenon that is inversely related to the residual ovarian reserve rather than to age. From a mathematical perspective, this kind of regulation intrinsically attenuates the effects of an early loss of a significant amount of primordial follicles. In conclusion, the detrimental effects of chemotherapy on natural fertility may be less severe if women with a history of chemotherapy during childhood seek for pregnancy early. This information should be part of the counseling.

Chemotherapy-related damage to ovarian reserve in childhood cancer survivors : interpreting the evidence / E. Somigliana, M. Terenziani, F. Filippi, A. Bergamini, F. Martinelli, G. Mangili, F. Peccatori, P. Vercellini. - In: JOURNAL OF ASSISTED REPRODUCTION AND GENETICS. - ISSN 1058-0468. - (2018 Oct 25). [Epub ahead of print] [10.1007/s10815-018-1345-8]

Chemotherapy-related damage to ovarian reserve in childhood cancer survivors : interpreting the evidence

E. Somigliana
Primo
;
M. Terenziani;F. Filippi;F. Martinelli;P. Vercellini
Ultimo
2018-10-25

Abstract

Chemotherapy during childhood damages ovarian reserve and can affect future fertility. However, recent large epidemiological studies showed that the detrimental impact on fertility is less severe if women seek for pregnancy at a younger age. To explain this observation, we hypothesize that the detrimental effects of previous chemotherapy on the ovarian reserve may be attenuated in young adults for two main reasons. Firstly, recent evidence showed that the amount of ovarian reserve is not a critical factor for effective natural conceptions. Provided that the residual ovarian reserve allows regular ovulatory cycles, the chances of pregnancy are similar in women with intact or reduced ovarian reserve. Secondly, ovarian reserve depletion appears to be a phenomenon that is inversely related to the residual ovarian reserve rather than to age. From a mathematical perspective, this kind of regulation intrinsically attenuates the effects of an early loss of a significant amount of primordial follicles. In conclusion, the detrimental effects of chemotherapy on natural fertility may be less severe if women with a history of chemotherapy during childhood seek for pregnancy early. This information should be part of the counseling.
Chemotherapy; Childhood cancer; Infertility; Ovarian reserve; Survivor
Settore MED/40 - Ginecologia e Ostetricia
Settore MED/06 - Oncologia Medica
25-ott-2018
Article (author)
File in questo prodotto:
File Dimensione Formato  
Somigliana et al., 2018.pdf

embargo fino al 17/01/2020

Tipologia: Post-print, accepted manuscript ecc. (versione accettata dall'editore)
Dimensione 326.79 kB
Formato Adobe PDF
326.79 kB Adobe PDF Visualizza/Apri
Somigliana2018_Article_Chemotherapy-relatedDamageToOv.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 537.93 kB
Formato Adobe PDF
537.93 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/598154
Citazioni
  • ???jsp.display-item.citation.pmc??? 3
  • Scopus 9
  • ???jsp.display-item.citation.isi??? 7
social impact