Department of Reproductive Medicine and Fertility Preservation, Université Paris-Saclay, Assistance publique Hôpitaux de Paris, Antoine Beclere Hospital, 92140, Clamart, France; Université Paris Saclay, Inserm, physiologie et physiopathologie endocrinienne, 94276, Le Kremlin-Bicêtre, France.
Université Paris Saclay, Inserm, physiologie et physiopathologie endocrinienne, 94276, Le Kremlin-Bicêtre, France.
Ann Endocrinol (Paris). 2023 May;84(3):382-387. doi: 10.1016/j.ando.2023.03.013. Epub 2023 Mar 24.
Chemotherapy to treat cancer is usually responsible for early ovarian follicle depletion. Ovarian damage induced by cancer treatments frequently results in infertility in surviving patients of childbearing age. Several fertility preservation techniques have been developed. Nowadays, oocyte or embryo cryopreservation with or without ovarian stimulation and cryopreservation of the ovarian cortex are the most commonly used. However, these methods may be difficult to implement in some situations, and subsequent use of the cryopreserved germ cells remains uncertain, with no guarantee of pregnancy. Improved knowledge of the molecular mechanisms and signaling pathways involved in chemotherapy-induced ovarian damage is therefore necessary, to develop new strategies for fertility preservation. The effects of various chemotherapies have been studied in animal models or in vitro on ovarian cultures, suggesting various mechanisms of gonadotoxicity. Today the challenge is to develop molecules and techniques to limit the negative impact of chemotherapy on the ovaries, using experimental models, especially in animals. In this review, the various theories concerning ovarian damage induced by chemotherapy will be reviewed and emerging approaches for ovarian protection will be explained.
化疗治疗癌症通常会导致早期卵巢卵泡耗竭。癌症治疗引起的卵巢损伤经常导致生育期幸存患者不孕。已经开发了几种生育力保存技术。如今，卵母细胞或胚胎冷冻保存（有或没有卵巢刺激）和卵巢皮质冷冻保存是最常用的方法。然而，在某些情况下，这些方法可能难以实施，并且随后使用冷冻保存的生殖细胞仍然不确定，不能保证怀孕。因此，有必要深入了解化疗引起的卵巢损伤的分子机制和信号通路，以开发新的生育力保存策略。各种化疗药物在动物模型或卵巢培养物中的作用已在动物模型或卵巢培养物中进行了研究，提示了各种性腺毒性机制。如今的挑战是使用实验模型，特别是动物模型，开发限制化疗对卵巢负面影响的分子和技术。在这篇综述中，将回顾化疗引起的卵巢损伤的各种理论，并解释新兴的卵巢保护方法。
