How to protect ovarian function before and during chemotherapy?

Luca Arecco, Tommaso Ruelle, Valentino Martelli, Andrea Boutros, Maria Maddalena Latocca, Stefano Spinaci, Camilla Marrocco, Claudia Massarotti, Matteo Lambertini

Research output: Contribution to journalReview articlepeer-review


A significant number of women receive a cancer diagnosis before their age of natural menopause. Among these patients, the most frequent neoplasms are breast cancer, gynecological, and hematological malignancies. Premature ovarian insufficiency and infertility are among the most feared short-to long-term consequences of anticancer treatments in premenopausal patients. Both patient-and treatment-related characteristics are key factors in influencing the risk of gonadotoxicity with the use of chemotherapy. The cryopreservation of oocytes/embryos is a standard strategy for fertility preservations offered to young women interested in future family planning, but it does not allow gonadal function protection during chemotherapy. Ovarian suppression with gonadotropin-releasing hormone agonist (GnRHa) during chemotherapy is now recommended as an option to reduce the risk of gonadotoxicity in order to avoid the negative consequences of premature ovarian insufficiency in premenopausal women receiving cytotoxic therapy, including those not interested in fertility preservation. This review summarizes the risk of treatment-induced gonadotoxicity in premenopausal patients and the evidence available on the protective role of administering GnRHa during chemotherapy to preserve ovarian function.

Original languageEnglish
Pages (from-to)4192
JournalJournal of Clinical Medicine
Issue number18
Publication statusPublished - Sep 2021


  • Cancer
  • Ovarian function preservation
  • Premature ovarian insufficiency
  • Premenopausal patients

ASJC Scopus subject areas

  • Medicine(all)


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