Conservative Management of Reproductive Cancers. Ovarian Protection During Treatment

Publication date: Available online 28 June 2018 Source:Best Practice & Research Clinical Obstetrics & Gynaecology Author(s): Wanyuan Cui, Kelly-Anne Phillips Globally, breast cancer is the most common female reproductive cancer. Although not part of initial curative-intent treatment in women with other reproductive cancers, alkylating chemotherapy is often used to treat women with curable breast cancer. Chemotherapy-associated ovarian failure (COF) is a potential consequence of this treatment, and can cause infertility and increase the risk of cognitive impairment, cardiovascular disease and fractures from reduced bone mineral density. Although cryopreservation of embryos and oocytes is often effective for fertility preservation, this does not prevent COF and its associated complications. Randomised trials, predominantly of women undergoing alkylating chemotherapy for breast cancer, have shown evidence for the efficacy of gonadotropin releasing hormone agonists (GnRHa) in reducing the risk of COF. Concurrent GnRHa use should be considered for all premenopausal women due to commence alkylating chemotherapy for curable cancer, regardless of their childbearing status, to further improve survivorship for women diagnosed with cancer.
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - Category: OBGYN Source Type: research