Cancer Treatment-Related Ovarian Dysfunction in Women of Childbearing Potential: Management and Fertility Preservation Options

PURPOSE To review the complex concerns of oncofertility created through increased cancer survivorship and the long-term effects of cancer treatment in young adults. DESIGN Review chemotherapy-induced ovarian dysfunction, outline how fertility may be addressed before treatment initiation, and discuss barriers to oncofertility treatment and guidelines for oncologists to provide this care to their patients. CONCLUSION In women of childbearing potential, ovarian dysfunction resulting from cancer therapy has profound short- and long-term implications. Ovarian dysfunction can manifest as menstrual abnormalities, hot flashes, night sweats, impaired fertility, and in the long term, increased cardiovascular risk, bone mineral density loss, and cognitive deficits. The risk of ovarian dysfunction varies between drug classes, number of received lines of therapy, chemotherapy dosage, patient age, and baseline fertility status. Currently, there is no standard clinical practice to evaluate patients for their risk of developing ovarian dysfunction with systemic therapy or means to address hormonal fluctuations during treatment. This review provides a clinical guide to obtain a baseline fertility assessment and facilitate fertility preservation discussions. (c) 2023 by American Society of Clinical Oncology

Automated summary

This article reviews the complex concerns of oncofertility caused by increased cancer survivorship and the long-term effects of cancer treatment in young adults. It discusses chemotherapy-induced ovarian dysfunction, the need for addressing fertility before treatment initiation, barriers to oncofertility treatment, and guidelines for oncologists to provide this care. The conclusion emphasizes the profound short- and long-term implications of ovarian dysfunction in women of childbearing potential, including menstrual abnormalities, impaired fertility, and increased cardiovascular risk. The review highlights the lack of standard clinical practice to evaluate the risk of ovarian dysfunction and provides a clinical guide for fertility assessment and preservation discussions.