Fertility Preservation and Long-Term Monitoring of Gonadotoxicity in Girls, Adolescents and Young Adults Undergoing Cancer Treatment

Michalczyk, Kaja; Cymbaluk‐Płoska, Aneta

doi:10.3390/cancers13020202

Cited by 31 publications

(20 citation statements)

References 114 publications

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“…In female patients of childbearing age and with reproductive intentions, fertility status should be assessed with hormone tests and ultrasound (please see the dedicated systematic review on fertility preservation and follow-up for this patient population) [15]. Hormone blood tests with LH, FSH and estradiol measurement may also be recommended after a clinical evaluation of symptomatic patients with hot flashes, amenorrhea and/or irregular periods [55,56].…”

Section: Summary Of Findingsmentioning

confidence: 99%

Late Endocrine and Metabolic Sequelae and Long-Term Monitoring of Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors: A Systematic Review by the Fondazione Italiana Linfomi

Molfetta

Daniele

Gerardi

et al. 2022

Cancers

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Background: Overall survival after lymphoma has improved in recent years, but the high prevalence of late treatment-related sequelae has been observed as a counterpart. Method: In this systematic review, FIL researchers aimed to: (i) estimate the incidence or prevalence of late endocrine-metabolic sequelae, (ii) evaluate the effects of modern therapeutic approaches on incidence or prevalence of late endocrine-metabolic sequelae, and (iii) determine whether there is evidence of follow-up schemes for their screening/early diagnosis in the subset of long-term classical Hodgkin lymphoma (cHL) and diffuse large B-cell lymphoma (DLBCL) survivors treated at adult age. The MEDLINE, Embase and the Cochrane Library databases were searched for relevant articles published up to October, 2020. The study selection process was conducted by three independent reviewers and was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A risk of bias assessment was performed using the Cochrane tool for randomized trials and the Newcastle-Ottawa Scale for observational studies. Results: In the final analysis, eight studies were included, four of which focused on thyroid disease, two on gonadal dysfunction, one on bone disease and one on metabolic syndrome. Hypothyroidism was reported in up to 60% of adult cHL survivors and was frequently recorded even with modern radiotherapy approaches. Menopause occurred in 52–72% of women after chemotherapy. An 86% reduction in vertebral density was reported following R-CHOP-like chemotherapy. Sarcopenia and metabolic syndrome were reported in 37.9% and 60% of patients, respectively. No validated screening protocols were found for the early diagnosis of long-term treatment-related endocrine and metabolic sequelae, thus the authors finally suggest the execution of screening exams according to the risk category which were identified in the epidemiologic studies.

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Section: Summary Of Findingsmentioning

confidence: 99%

Late Endocrine and Metabolic Sequelae and Long-Term Monitoring of Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors: A Systematic Review by the Fondazione Italiana Linfomi

Molfetta

Daniele

Gerardi

et al. 2022

Cancers

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“…OTC is currently a unique option for prepubescent girls and patients whose gonadotoxic treatment delay or conventional ovarian stimulation is contraindicated [ 116 , 117 ]. Moreover, because of the rich source of PFs in young patients, OTC could yield the greatest fertility potential in CCS [ 115 , 118 , 119 , 120 ]. OTC could also be a beneficial option for patients who underwent chemotherapy because chemotherapy is no longer a contraindication to freezing, as demonstrated by previous studies [ 80 ].…”

Section: The Therapeutic Options For Fpmentioning

confidence: 99%

Female Oncofertility: Current Understandings, Therapeutic Approaches, Controversies, and Future Perspectives

Kawamura

2021

JCM

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Recent advances in early detection and oncological therapies have ameliorated the survival rate of young cancer patients. Yet, ovarian impairment induced by chemotherapy and radiotherapy is still a challenging issue. This review, based on clinical and lab-based studies, summarizes the evidence of gonadotoxicity of chemoradiotherapy, the recent approaches, ongoing controversies, and future perspectives of fertility preservation (FP) in female patients who have experienced chemo- or radio-therapy. Existing data indicate that chemotherapeutic agents induce DNA alterations and massive follicle activation via the phosphoinositide 3-kinase (PI3K)/Akt signaling pathway. Meanwhile, the radiation causes ionizing damage, leading to germ cell loss. In addition to the well-established methods, numerous therapeutic approaches have been suggested, including minimizing the follicle loss in cryopreserved ovarian grafts after transplantation, in vitro activation or in vitro growing of follicles, artificial ovarian development, or fertoprotective adjuvant to prevent ovarian damage from chemotherapy. Some reports have revealed positive outcomes from these therapies, whereas others have demonstrated conflictions. Future perspectives are improving the live birth rate of FP, especially in patients with adverse ovarian reserve, eliminating the risk of malignancy reintroducing, and increasing society’s awareness of FP importance.

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“…19 Besides, oocyte in vitro maturation is still in the experimental phase. 20 Some authors have recommended ovarian tissue cryopreservation (OTC) to preserve fertility in girls treated for cancer. In contrast to oocyte cryopreservation, functional ovarian tissue is cryogenically stored in OTC (removing part of the ovary or its cortex), which is currently the only promising fertility preservation method in prepubertal cancer patients.…”

Section: Prepubertal Girlsmentioning

confidence: 99%

Fertility Preservation Methods in Childhood and Adolescence Cancers: A Review.

Şiraz

HATİPOĞLU>

2021

J. Pediatr. Acad.

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In childhood and adolescence cancers; survival rates increase with the use of treatment options such as chemotherapy, radiotherapy and hematopoietic stem cell transplantation. One of the long-term effects of primary disease and cancer treatment is the irreversible damage to gonadal tissues, resulting in impaired fertility. Especially chemotherapeutic drugs; causes germ cell defect, affects the secretion of pituitary hormone, and also damages the anatomical structures of internal genital structures such as the uterus. Gonadal preservation methods are limited in prepubertal male patients. It is a good option to place the testicles in a different area before radiotherapy. Before chemotherapy or whole body irradiation, freezing of testicular tissue and ensuring pregnancy from frozen tissue is still in the experimental stage. After the ejaculation begins, obtaining and storing sperm is successfully done. A limited number of pregnancies were obtained oocytes frozen ovaries in the prepubertal girls. It is possible to freeze oocytes after puberty begins. In addition, recently, as a noninvasive method, gonadotropin-releasing hormone (GnRH) analogues have been used successfully, as it suppresses the hypothalamic-pituitary-gonadal axis and protects germ cells from cytotoxic effects. This article aims to provide information on fertility preservation methods in patients receiving childhood cancer treatment.

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Fertility Preservation and Long-Term Monitoring of Gonadotoxicity in Girls, Adolescents and Young Adults Undergoing Cancer Treatment

Cited by 31 publications

References 114 publications

Late Endocrine and Metabolic Sequelae and Long-Term Monitoring of Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors: A Systematic Review by the Fondazione Italiana Linfomi

Late Endocrine and Metabolic Sequelae and Long-Term Monitoring of Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors: A Systematic Review by the Fondazione Italiana Linfomi

Female Oncofertility: Current Understandings, Therapeutic Approaches, Controversies, and Future Perspectives

Fertility Preservation Methods in Childhood and Adolescence Cancers: A Review.

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