Chemotherapy and decline of the ovarian reserve: how can we explain it and how to prevent it?

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Fertility and Sterility
Editorial Office, American Society for Reproductive Medicine
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VOLUME 114, ISSUE 4, P722-724

Author:

Jacques Donnez, MD, PhD

Abstract:

Understanding how chemotherapy affects gonadal function also allows us to understand the mechanisms protecting the pool of primordial follicles (namely, the ovarian reserve), and provides valuable insights into gonadoprotective agents that can be used to counter the adverse effects of toxic drugs. The effects of chemotherapeutic drugs on female reproduction began to be reported in the 1970s. The first accounts associated one particular alkylating agent, cyclophosphamide (CPM), with amenorrhea, premature ovarian insufficiency (POI), and ovarian dysfunction. Alkylating agents are derived originally from mustard gas chemical warfare agents. Cyclophosphamide is a prodrug and its primary active metabolite is phosphoramide mustard, inducing DNA crosslinking and finally preventing DNA replication (1).

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.