Hormonal Suppression for Ovarian Protection

Fertility and ovarian protection against chemotherapy-associated ovarian damage has formed a new field called oncofertility, which is driven by the pursuit of fertility protection as well as good life quality for numerous female cancer survivors. However, the choice of fertility and ovarian protection method is a difficult problem during chemotherapy and there is no uniform guideline at present. To alleviate ovarian toxicity caused by anticancer drugs, effective methods combined with an individualized treatment plan that integrates an optimal strategy for preserving and restoring reproductive function should be offered from well-established to experimental stages before, during, and after chemotherapy. Although embryo, oocyte, and ovarian tissue cryopreservation are the major methods that have been proven effective and feasible for fertility protection, they are also subject to many limitations. Therefore, this paper mainly discusses the future potential methods and corresponding mechanisms for fertility protection in chemotherapy-associated ovarian damage.

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The Paracrine Effect of Transplanted Human Amniotic Epithelial Cells on Ovarian Function Improvement in a Mouse Model of Chemotherapy-Induced Primary Ovarian Insufficiency

Stem Cells International ◽

10.1155/2016/4148923 ◽

2016 ◽

Vol 2016 ◽

pp. 1-14 ◽

Cited By ~ 15

Author(s):

Xiaofen Yao ◽

Yuna Guo ◽

Qian Wang ◽

Minhua Xu ◽

Qiuwan Zhang ◽

...

Keyword(s):

Epithelial Cells ◽

Ovarian Function ◽

Immunohistochemical Analysis ◽

Primary Ovarian Insufficiency ◽

Pcr Analysis ◽

Mice Model ◽

Ovarian Insufficiency ◽

Paracrine Effect ◽

Ovarian Protection ◽

Amnion Epithelial Cells

Human amnion epithelial cells (hAECs) transplantation via tail vein has been reported to rescue ovarian function in mice with chemotherapy-induced primary ovarian insufficiency (POI). To test whether intraperitoneally transplanted hAECs could induce therapeutic effect and to characterize the paracrine effect of transplanted hAECs, we utilized a chemotherapy induced mice model of POI and investigated the ability of hAECs and conditioned medium collected from cultured hAECs (hAECs-CM) to restore ovarian function. We found that transplantation of hAECs or hAECs-CM either 24 hours or 7 days after chemotherapy could increase follicle numbers and partly restore fertility. By PCR analysis of recipient mice ovaries, the presence of SRY gene was only detected in mice transplanted with male hAECs 24 hours following chemotherapy. Further, the gene expression level of VEGFR1 and VEGFR2 in the ovaries decreased, although VEGFA increased 2 weeks after chemotherapy. After treatment with hAECs or hAEC-CM, the expression of both VEGFR1 and VEGFR2 increased, consistent with the immunohistochemical analysis. In addition, both hAECs and hAECs-CM treatment enhanced angiogenesis in the ovaries. The results suggested that hAECs-CM, like hAECs, could partly restore ovarian function, and the therapeutic function of intraperitoneally transplanted hAECs was mainly induced by paracrine-mediated ovarian protection and angiogenesis.

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OVARIAN PROTECTION IN MICE PRETREATED WITH LH-RH ANALOGS BEFORE IRRADIATION

Radiation Research: A Twentieth-century Perspective ◽

10.1016/b978-0-12-168561-4.50603-x ◽

1991 ◽

pp. 155

Author(s):

T.L. Walden ◽

N.K. Farzaneh ◽

A.V. Schally

Keyword(s):

Ovarian Protection ◽

Lh Rh

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Advances in Fertility Preservation for Young Women With Cancer

American Society of Clinical Oncology Educational Book ◽

10.1200/edbk_208301 ◽

2018 ◽

pp. 27-37 ◽

Cited By ~ 3

Author(s):

Karen Lisa Smith ◽

Clarisa Gracia ◽

Anna Sokalska ◽

Halle Moore

Keyword(s):

Fertility Preservation ◽

Young Female ◽

Current Data ◽

Reproductive Age ◽

Fertility Treatment ◽

Ovarian Suppression ◽

Female Patients ◽

Ovarian Protection ◽

Future Fertility ◽

Reproductive Techniques

Female patients of reproductive age with cancer often require treatment that can compromise their future fertility. Treatment-related infertility is an important cancer survivorship issue and is associated with depression and diminished quality of life. Recent advances in reproductive health care provide the opportunity to preserve fertility prior to the initiation of cancer therapy. Clinical guidelines recommend that oncology providers counsel patients about the risk of treatment-related infertility and fertility preservation options, and that they refer those who are interested in fertility preservation to fertility specialists. Guidelines endorse the use of assisted reproductive techniques (ART) provided by reproductive endocrinologists to preserve fertility in young female patients with cancer. In addition, ovarian suppression with gonadotropin-releasing hormone (GnRH) agonists may be considered for ovarian protection during chemotherapy. This article reviews currently available and emerging ART for fertility preservation in female patients of reproductive age with cancer and current data supporting the use of ovarian suppression for ovarian protection during chemotherapy in this population. We also review the uptake of fertility services and discuss barriers to fertility preservation in female patients of reproductive age with cancer.

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138. How Acceptable is Ovarian Protection to Woman of Childbearing Age Treated with Cyclophosphamide: Experience at a Single Centre

Rheumatology ◽

10.1093/rheumatology/kev089.025 ◽

2015 ◽

Cited By ~ 1

Keyword(s):

Childbearing Age ◽

Single Centre ◽

Ovarian Protection

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Ovarian protection with goserelin during adjuvant chemotherapy for pre-menopausal women with early breast cancer (EBC)

Breast Cancer Research and Treatment ◽

10.1007/s10549-007-9745-y ◽

2007 ◽

Vol 110 (3) ◽

pp. 411-416 ◽

Cited By ~ 50

Author(s):

Ander Urruticoechea ◽

Monica Arnedos ◽

Geraldine Walsh ◽

Mitch Dowsett ◽

Ian E. Smith

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Early Breast Cancer ◽

Ovarian Protection ◽

Menopausal Women

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The relative value of anti-Müllerian hormone to predict premature menopause in patients receiving adjuvant chemotherapy for breast cancer: Results from the OPTION trial.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.1094 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 1094-1094 ◽

Cited By ~ 2

Author(s):

Robert C. F. Leonard ◽

Douglas Adamson ◽

Gianfilippo Bertelli ◽

Michelle McLinden ◽

Nan Haiying ◽

...

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Multivariate Logistic Regression Analysis ◽

Premenopausal Women ◽

Menstrual Bleeding ◽

Premature Menopause ◽

Ovarian Activity ◽

Ovarian Protection ◽

Pre Treatment

1094 Background: The OPTION trial in premenopausal women tested the ovarian protection effect of goserelin (G) given randomly before and during adjuvant chemotherapy for breast cancer. Methods: Using standard chemotherapy, women were randomised in 2 strata, under 40 yrs and over 40 yrs at diagnosis. 227 patients were recruited by end December 2009. 173 met the criteria for 1 year follow-up for this analysis; 140 patients of these had provided adequate data on menstrual bleeding; 87 patients were aged under 40 and 53 patients were aged over 40 at the time of chemotherapy. Cessation of menstruation during chemotherapy was defined as at least two consecutive cycles with no menstrual bleeding since the previous cycle and no return of menstrual bleeding prior to the final cycle of chemotherapy. Of those patients who had ceased periods during chemotherapy, those with no further menstrual bleeding at 12 months follow up were deemed to be menopausal. Patients were randomised to receive G or no G at start of chemotherapy. Primary endpoint was recovery of menses at 12 months from start of chemotherapy. AMH was measured in 117 women pre-treatment, and at 1 year after starting chemotherapy. Results: There were no differences in pretreatment AMH between control and goserelin-treated groups, thus further analyses were performed on all women grouped together. AMH was lower following chemotherapy (0.40±0.65 vs 1.38±1.82ng/ml; mean±SD; P<0.001)). Pre-treatment AMH was a significant predictor of post-treatment amenorrhoea (P=0.001). By multivariate logistic regression analysis with age and AMH, age remained significant (P=0.003) whereas AMH did not (P=0.07). Grouping pre-treatment and post-chemo AMH into quartiles showed that AMH became undetectable in 94% of women with lowest pre-treatment AMH vs 46.2% of women with the highest pretreatment AMH. We have previously demonstrated in a small cohort that pretreatment AMH can predict long-term (5 year) ovarian activity in women with breast cancer. Conclusions: The present data confirm the value of pretreatment AMH in assessing the likelihood of ongoing ovarian activity after chemotherapy for early breast cancer.

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