reproductive late effects in female survivors of childhood cancer在女性生殖后遗症儿童癌症的幸存者.pdfVIP

Hindawi Publishing Corporation Obstetrics and Gynecology International Volume 2012, Article ID 564794, 7 pages doi:10.1155/2012/564794 Review Article Reproductive Late Effects in Female Survivors of Childhood Cancer Shivany Gnaneswaran,1 Rebecca Deans,1, 2, 3 and Richard J. Cohn1, 3 1 University of New South Wales, Sydney, NSW 2052, Australia 2 Royal Hospital for Women, Barker Street, Randwick, NSW 2031, Australia 3 Centre for Children’s Cancer and Blood Disorders, Sydney Children’s Hospital, High Street, Randwick, NSW 2031, Australia Correspondence should be addressed to Richard J. Cohn, richard.cohn@.au Received 26 October 2011; Revised 27 December 2011; Accepted 25 January 2012 Academic Editor: Catherine Poirot Copyright © 2012 Shivany Gnaneswaran et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Childhood cancer treatments can cause female reproductive late effects. Radiation to the hypothalamic-pituitary-ovarian axis is associated with altered menarche, miscarriage, and implantation failure. Patients who receive chemotherapy and/or ovarian radiation are at risk of premature ovarian failure; the risk increases with increasing radiation dose, alkylating agent score, combination therapy, and older age at treatment. Ovarian reserve may be assessed using antimullerian hormone assay and ultrasound measurements of ovarian volume and antral follicle count; however, their efficacy is poorly established in this cohort. Fertility preservation options including cryopreservation, oophoropexy, and gonadotropin-releasing hormone analogues may be initiated prior to treatm