Pharmacological options for the protection of ovarian function in patients undergoing chemotherapy

Abstract

Chemotherapy, particularly alkylating agents, can be toxic to germ cells, and may lead to treatment amenorrhoea in young women. The age at which chemotherapy is administered is a strong predictor of subsequent premature ovarian failure, with older patients being at the highest risk. Smaller primordial follicles may survive the insult of chemotherapy better, and the suppression of follicle development may protect the germ cell pool. The suppression of follicle development by gonadotrophin-releasing hormone agonists (or antagonists) or combined oral contraceptives has been reported in the literature. The results are promising, but conflicting reports on the protection makes further studies essential.