Effect of first line cancer treatment on the ovarian reserve and follicular density in girls under the age of 18 years.

Autor:	El Issaoui M; Laboratory of Reproductive Biology, Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Giorgione V; Laboratory of Reproductive Biology, Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Mamsen LS; Laboratory of Reproductive Biology, Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Rechnitzer C; Department of Paediatrics and Adolescent Medicine, Juliane Marie Centre, Copenhagen University Hospital, Copenhagen, Denmark., Birkebæk N; Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark., Clausen N; Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark., Kelsey TW; School of Computer Science, University of St. Andrews, St. Andrews, United Kingdom., Andersen CY; Laboratory of Reproductive Biology, Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. Electronic address: yding@rh.dk.
Jazyk:	angličtina
Zdroj:	Fertility and sterility [Fertil Steril] 2016 Dec; Vol. 106 (7), pp. 1757-1762.e1. Date of Electronic Publication: 2016 Oct 04.
DOI:	10.1016/j.fertnstert.2016.09.001
Abstrakt:	Objective: To study the impact of first-line antineoplastic treatment on ovarian reserve in young girls returning for ovarian tissue cryopreservation (OTC) in connection with a relapse. Design: Retrospective case-control study. Setting: University hospitals. Patient(s): Sixty-three girls under the age of 18 years who underwent OTC before (group 1: 31 patients) and after (group 2: 32 patients) their initial cancer treatment. Intervention(s): None. Main Outcome Measure(s): Follicular densities (follicles/mm 3 ) measured from an ovarian cortical biopsy before OTC. The ovarian volume (mL) of entire ovaries excised for OTC was also monitored. Result(s): There was no statistically significant difference in the mean age or follicular density between groups 1 and 2 (334 ± 476/mm 3 vs. 327 ± 756/mm 3 ). In contrast, the ovarian volume and total number of ovarian cortex chips cryopreserved were statistically significantly lower in patients who received gonadotoxic treatment before OTC (mean ± standard deviation [SD]: ovarian volume, 5.3 ± 3.1 mL vs. 2.9 ± 2.1 mL, respectively; number of cortex chips: 21.3 ± 8.1 vs. 15.2 ± 7.1, respectively). The reduction in the estimated ovarian reserve ranged from 10% to 20% in children to around 30% in adolescent girls (>10 years). Conclusion(s): Girls under the age of 10 tolerate a gonadotoxic insult better than adolescents, who may experience up to a 30% reduction in the ovarian reserve via first-line gonadotoxic treatment, which at present is considered to have little effect on the follicle pool. This information will improve counseling of young female cancer patients in deciding whether to undergo fertility preservation treatment. (Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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