Fertility Preservation in Girls and Adolescents Before Chemotherapy and Radiation – Review of the Literature

Abstract

There has been a significant improvement in survival rates over the last decade as a result of advances in the treatment of cancer in children. One of the consequences of chemotherapy may be damage to the ovarian function, which can lead to loss of fertility. Methods of fertility protection have been developed for adult women as a result of advances in reproductive medicine, which make the option of becoming pregnant after surviving cancer realistic. However, only some of the methods can be used in prepubescent girls and adolescents. In addition, a higher number of miscarriages and premature births have been found in women who underwent pelvic radiotherapy during childhood or adolescence and the children were more commonly growth retarded. The effects of cancer treatment on the ovarian function and later fertility should be discussed at the start of treatment.

Zusammenfassung

Die Krebsbehandlung bei Kindern führt zu höhen Überlebensraten. Eine der Folgen einer Chemotherapie in der Kindheit kann eine Schädigung der Eierstocksfunktion bis zur Infertilität sein. Durch Fortschritte in der Reproduktionsmedizin sind für erwachsene Frauen fertilitätsprotektive Techniken entwickelt worden, die die Option einer Schwangerschaft nach überstandener Erkrankung realistisch erscheinen lassen. Allerdings lässt sich nur ein Teil der Maßnahmen auf präpubertäre Mädchen und Adoleszentinnen übertragen. Allerdings fanden sich bei Frauen, die in der Kindheit oder in der Adoleszenz eine Radiatio im Beckenbereich hatten, erhöhte Raten an Fehl- und Frühgeburten und die Kinder waren häufiger wachstumsretardiert. Der Einfluss der Krebstherapie auf die Eierstocksfunktion und die spätere Fruchtbarkeit sind bereits zu Therapiebeginn zu thematisieren.

Key Words

fertility preserving methods - childhood cancer - girls - adolescents - ovarian toxicity - fertility

Schlüsselwörter

fertilitätserhaltende Maßnahmen - Krebs in der Kindheit - Mädchen - Adoleszentinnen - Ovartoxizität - Fertilität

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