Gonadotoxicity of Cancer Therapies in Pediatric and Reproductive-Age Females

In the United States, almost 120,000 females under the age of 50 years are diagnosed with cancer annually [ 1 ] . Retaining reproductive potential is extremely important to those diagnosed with cancer, and reproductive compromise can cause distress well into survivorship [ 2, 3 ] . Despite this, patients often do not recall discussions at diagnosis regarding fertility and options for fertility preservation [ 4, 5 ] . Barriers to these discussions are myriad [ 6 ] but include a lack of knowledge of the risk for reproductive compromise [ 7 ] in individual premenopausal female patients diagnosed with cancer. It is of critical importance to attempt to understand the factors, both treatmentand host-related, that impact the ability of cancer survivors to have biological children posttreatment. This chapter will summarize normal female reproductive physiology; address the gonadotoxic impact of chemotherapeutic agents, radiation therapy, and surgical intervention on reproductive function; and brie fl y discuss the current methodologies available for assessing reproductive potential after cancer treatment.