Consequences of chemotherapeutic agents on primordial follicles and future clinical applications

So Youn Kim, Geum Joon Cho, John S. Davis

    Research output: Contribution to journalReview articlepeer-review

    13 Citations (Scopus)


    The ovarian reserve is necessary for female fertility and endocrine health. Commonly used cancer therapies diminish the ovarian reserve, thus, resulting in primary ovarian insufficiency, which clinically presents as infertility and endocrine dysfunction. Prepubertal children who have undergone cancer therapies often experience delayed puberty or cannot initiate puberty and require endocrine support to maintain a normal life. Thus, developing an effective intervention to prevent loss of the ovarian reserve is an unmet need for these cancer patients. The selection of adjuvant therapies to protect the ovarian reserve against cancer therapies underlies the mechanism of loss of primordial follicles (PFs). Several theories have been proposed to explain the loss of PFs. The "burn out" theory postulates that chemotherapeutic agents activate dormant PFs through an activation pathway. Another theory posits that chemotherapeutic agents destroy PFs through an "apoptotic pathway" due to high sensitivity to DNA damage. However, the mechanisms causing loss of the ovarian reserve remains largely speculative. Here, we review current literature in this area and consider the mechanisms of how gonadotoxic therapies deplete PFs in the ovarian reserve.

    Original languageEnglish
    Pages (from-to)382-390
    Number of pages9
    JournalObstetrics and Gynecology Science
    Issue number6
    Publication statusPublished - 2019

    Bibliographical note

    Publisher Copyright:
    © 2019 Korean Society of Obstetrics and Gynecology.


    • Fertility
    • Fertility preservation
    • Ovarian follicle
    • Primary ovarian insufficiency

    ASJC Scopus subject areas

    • Obstetrics and Gynaecology


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