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

Meryam El Issaoui, Veronica Giorgione, Linn Salto Mamsen, Catherine Rechnitzer, Niels Birkebæk, Niels Clausen, Thomas W Kelsey, Claus Yding Andersen

13 Citations (Scopus)

Abstract

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.

Original languageEnglish
JournalFertility and Sterility
Volume106
Issue number7
Pages (from-to)1757-1762.e1
Number of pages6
ISSN0015-0282
DOIs
Publication statusPublished - 1 Dec 2016

Keywords

  • Journal Article

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