The past decade has witnessed an increase in cancer survival rates1. Fertility preservation for young women destined to undergo treatment with chemotherapy or radiotherapy has become a significant issue, with future childbearing being a powerful stimulus to get well2. Only half the patients who discussed fertility issues with their doctors believe that their concerns were adequately addressed3—a situation that is probably attributable to the fact that, although most physicians are familiar with the toxic gonadal effect of alkylating agents, they are unaware of fertility preservation options and the effect of cancer per se on ovarian function.
Recent evidence demonstrated a negative effect of cancer on spermatogenesis, with a decrease in sperm quality and indices in patients diagnosed with hematologic and testicular cancers4,5. Likewise, the effect of cancer on baseline ovarian function and ovarian response to stimulation for in vitro fertilization ( ivf ) has been studied with mixed results. Various aspects of ovarian function and response to stimulation have been studied: baseline ovarian function and reserve, the effects of cancer on ovarian stimulation for ivf , and the effects of cancer on oocyte yield and fertilization rates.
Our aim was to review the available literature and to add the data from our large series of patients diagnosed with cancer so that physicians treating young women who desire to preserve fertility will be able to provide advice based on the available current and accumulating data.
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CKN Related Article: Survivorship Series, Fertility