Over the past two decades, advances in cancer therapy have significantly improved survival rates, particularly in childhood cancers. Still, many treatments pose a substantial risk for diminishing future fertility potential due to the gonadotoxic nature of many cancer regimens, justifying fertility preservation programs for both childhood and adult cancer patients. To assure a balance between offering fertility preservation and actual chance of infertility post-treatment, guidelines are in place. However, assessing the actual risk of infertility after treatment remains challenging, given the multi-faceted approach of many cancer treatment plans, which are continuously evolving. This review discusses the evolution of cancer therapy over the past 20 years and attempts to assess their impact on fertility after treatment. Overall, cancer regimens have shifted from broadly killing fast dividing cells to more targeting therapies, reducing collateral damage in general. Although progress has been made to reduce overall toxicity, unfortunately this does not automatically translate to reduced gonadotoxicity. Therefore, current fertility preservation programs continue to be an important part of cancer care.
Molecular aspects of medicine. 2024 Sep 10 [Epub ahead of print]
Kathleen Duffin, Rod T Mitchell, Mark F H Brougham, Geert Hamer, Ans M M van Pelt, Callista L Mulder
Department of Biomedical Sciences, University of Edinburgh, George Square, Edinburgh, EH8 9XD, UK; Royal Hospital for Children and Young People, 50 Little France Crescent, Edinburgh, EH16 4TJ, UK., Royal Hospital for Children and Young People, 50 Little France Crescent, Edinburgh, EH16 4TJ, UK; Centre for Reproductive Health, Institute of Regeneration and Repair, University of Edinburgh, 4-5 Little France Drive, Edinburgh BioQuarter, Edinburgh, EH16 4UU, UK., Royal Hospital for Children and Young People, 50 Little France Crescent, Edinburgh, EH16 4TJ, UK., Reproductive Biology Laboratory, Center for Reproductive Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands., Reproductive Biology Laboratory, Center for Reproductive Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands. Electronic address: ., Reproductive Biology Laboratory, Center for Reproductive Medicine, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands; Amsterdam Reproduction and Development Research Institute, Amsterdam, the Netherlands. Electronic address: .