Gonadal dysfunction and fertility problems in cancer survivors

@article{Brydy2007GonadalDA,
  title={Gonadal dysfunction and fertility problems in cancer survivors},
  author={Marianne Bryd{\o}y and Sophie D. Foss{\aa} and Olav Dahl and Trine Bj{\o}ro},
  journal={Acta Oncologica},
  year={2007},
  volume={46},
  pages={480 - 489}
}
Gonadal dysfunction and fertility problems are adverse effects of cancer treatment or may be associated with specific malignancies. This review focuses on these problems in the young cancer survivors, where methods of protecting or restoring endocrine function and fertility need to be considered. In females, treatment adverse effects can result in infertility, but premature ovarian failure (POF) is probably relevant for more female cancer survivors, affecting also those who do not wish post… 

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References

SHOWING 1-10 OF 74 REFERENCES

Male fertility following childhood cancer: current concepts and future therapies.

TLDR
In addition to the many scientific and technical issues to be overcome prior to clinical application of these techniques, a number of ethical and legal issues must also be addressed to ensure a safe and realistic prospect for future fertility in these patients.

The effects of cancer and cancer treatments on male reproductive function

TLDR
In male cancer patients, surgery, radiotherapy and chemotherapy can be followed by transient or permanent infertility by affecting ejaculatory or erectile function, or by impairing spermatogenesis, and fertility-preserving measures before and during treatment should be considered.

Fertility, gonadal and sexual function in survivors of testicular cancer

TLDR
Gonadal dysfunction is common in patients with a history of testicular cancer even when managed by orchidectomy alone and treatment with chemotherapy in particular can result in additional impairment.

Radiation damage to the uterus — Review of the effects of treatment of childhood cancer

TLDR
It has been demonstrated that, in women treated with total body irradiation, sex steroid replacement in physiological doses significantly increases uterine volume and endometrial thickness, as well as re-establishing uterine blood flow, however, it is not known whether standard regimens of oestrogen replacement therapy are sufficient to facilitate uterine growth in adolescent women treated in childhood.

Fertility preservation in young women undergoing breast cancer therapy.

TLDR
When and if a breast cancer patient does not have time to undergo ovarian stimulation prior to chemotherapy, ovarian cryopreservation for future autotransplantation can be offered as the last resort.

Treatment options for the infertile male with cancer.

TLDR
Advances in assisted reproductive techniques allow in vitro fertilization to occur with the injection of a single sperm into an egg (IVF-ICSI), consequently, the requirement for the amount of sperm needed from cryopreservation is minimal and spermatogonial cell transplantation offer the potential to restore fertility in patients who have received radiation or chemotherapy.

Fertility of long‐term male survivors of acute lymphoblastic leukemia diagnosed during childhood

TLDR
In this first study of proven fertility among men treated for childhood leukemia, the majority of survivors showed no evidence of fertility impairment compared to controls, however, men treated at a young age with high dose cranial RT may have impaired fertility.

Testicular dysgenesis syndrome: an increasingly common developmental disorder with environmental aspects.

TLDR
Existing evidence supporting a new concept that poor semen quality, testis cancer, undescended testis and hypospadias are symptoms of one underlying entity, the testicular dysgenesis syndrome (TDS), which may be increasingly common due to adverse environmental influences is summarized.

Male gonadal dysfunction in patients with Hodgkin's disease prior to treatment.

  • U. RuefferK. Breuer V. Diehl
  • Medicine, Biology
    Annals of oncology : official journal of the European Society for Medical Oncology
  • 2001
TLDR
Assuming HD is the major initial cause for infertility efforts should be made to identify new non-gonadal toxic chemotherapies to be able to regain fertility after effective therapy.

The impact of cancer therapy on the endocrine system in survivors of childhood brain tumours.

TLDR
Endocrine problems are very common in patients following cancer therapy for childhood brain tumours and the recognition and prompt management of these are essential to prevent further morbidity and impairment of quality of life.
...