Ways of protection of reproductive functions of women and men undergoing treatment with cytotoxic drugs


Authors: P. Němec 1;  M. Huser 2;  M. Souček 3
Authors‘ workplace: Revmatologická ambulance, II. interní klinika Lékařské fakulty Masarykovy Univerzity a FN u sv. Anny v Brně 1;  Centrum asistované reprodukce CAR 01, Gynekologicko-porodnická klinika Lékařské fakulty Masarykovy Univerzity a FN Brno, 3II. interní klinika Lékařské fakulty Masarykovy Univerzity a FN u sv. Anny v Brně 2
Published in: Čes. Revmatol., 16, 2008, No. 2, p. 81-88.
Category: Overview Reports

Overview

Therapy of serious organ affections in connective tissue diseases and systemic vasculitides often requires the use of cytostatics. Irreversible damage of gonads’ germinal tissue belongs to serious adverse effects of these drugs. Destruction of ovarian follicles leads to the primary ovarian insufficiency and to the development of subsequent infertility with symptoms of climacteric syndrome. Destruction of testicles can even lead to permanent azoospermia. The question of protection of reproductive functions of women and men has not been entirely answered yet. The overview of present ways of protection of reproductive functions of women and men undergoing the treatment with cytotoxic drugs including modern methods of assisted reproduction and new ways of pharmacological protection using gonadoliberin analogs is described in the text.

Key words:
assisted reproduction, GnRH analogs, infertility, connective tissue disease


Sources

1. Laml T, Schulz-Lobmeyr I, Obruca A, et al. Prematureovarian failure: etiology and prospects. Gynecol Endocrinol 2000; 14: 292-302.

2. Blumenfeld Z. How to preserve fertility in young women exposed to chemotherapy? The role of GnRH agonist cotreatment in addition to cryopreservation of embrya, oocytes, or ovaries. Oncologist 2007; 12: 1044–54.

3. Blumenfeld Z, Eckman A. Preservation of fertility and ovarian function and minimization of chemotherapy-induced gonadotoxicity in young women by GnRH-a. J Natl Cancer Inst Monogr 2005; 34: 40–3.

4. Blumenfeld Z, Shapiro D, Shteinberg M, et al. Preservation of fertility and ovarian function and minimizing gonadotoxicity in young women with systemic lupus erythematosus treated by chemotherapy. Lupus 2000; 9: 401–5.

5. Crha I, Ventruba P, Žáková J, et al. Kryokonzervace spermatu před gonadotoxickou léčbou – 11 let zkušeností. Čes Gynek 2007; 72: 320–6.

6. Silva CA, Hallak J, Pasqualotto FF, et al. Gonadal function in male adolescents and young males with juvenile onset systemic lupus erythematosus. J Rheumatol 2002; 29: 2000–5.

7. Rueffer U, Breuer K, Josting A, et al. Male gonadal dysfunction in patients with Hodgkin‘s disease prior to treatment. Ann Oncol 2002; 13: 333.

8. Ataya K, Rao LV, Laurence E, et al. Luteinizing hormone-releasing hormone agonist inhibits cyclophosphamide induced ovarian follicular depletion in Rhesus monkeys. Biol Reprod 1995; 52: 365–72.

9. Trasler JM, Hales BF, Robaire B. Chronic low dose cyclophosphamide treatment of adult male rats: effect on fertility, pregnancy outcome and progeny. Biol Reprod 1986; 34: 275–83.

10. Hoorweg-Nijman JJ, Delemarre-vande-Wall HA, DeWall FC, et al. Cyclophosphamide-induced disturbance of gonadotropin secretion manifesting testicular damage. Acta Endocrinol 1992; 126: 143–8.

11. Ghosh D, Das UB, Ghosh S, et al. Testicular gametogenic and steroidogenic activities in cyclophosphamide treated rat: a correlative study with testicular oxidative stress. Drug Chem Toxicol 2002; 25: 281–92.

12. Sancar A, Lindsey-Boltz LA, Unsal-Kacmaz K, et al. Molecular mechanisms of mammalian DNA repair and the DNA damage checkpoints. Annu Rev Biochem 2004; 73: 39–85.

13. Matsui H, Mitsumori K, Yasuhara K, et al. Morphological evaluation of cyclophosphamide testicular toxicity in rats using quantitative morphometry of spermatogenic cycle stages. J Toxicol Sci 1995; 20: 407–14.

14. Elangovan N, Chiou TJ, Tzeng WF, et al. Cyclophosphamide treatment cause impairment of sperm and its fertilizing ability in mice. Toxicology 2006; 222: 60–70.

15. Katoh C, Kitajima S, Saga Y, et al. Assessment of quantitative dual-parameter flow cytometric analysis for the evaluation of testicular toxicity using cyclophosphamide and ethinylestradiol treated rats. J Toxicol Sci 2002; 27: 87–96.

16. Irvine DS, Twigg JP, Gordon EL et al. DNA integrity in human spermatozoa: relationships with semen duality. J Nadrol 2000; 21: 33–44.

17. Kangasniemi M, Huhtaniemi I, Meistrich ML. Failure of spermatogenesis to recover despite the presence of a spermatogonia in the irradiated LBNF1 rat. Biol Reprod 1996; 54: 1200–8.

18. Boldt J, Cline D, McLaughlin D. Human oocyte cryopreservation as an adjunct to IVF-embryo transfer cycles. Hum reprod 2003; 18: 1250–5.

19. Quintans CJ, Donaldson MJ, Bartolino MV, et al. Birth of two babies oocytes that were cryopreserved in a choline-based freezing medium. Hum Reprod 2002; 17: 3149–52.

20. Marrs RP, Greene J, Stone BA. Potential factors affecting embryo survival and clinical outcome with cryopreserved pronuclear human embryos. Am J Obstet Gynecol 2004; 190: 1766–71; discussion 1771–2.

21. DęAngelo A, Amso NN. Embryo freezing for preventing ovarian hyperstimulation syndrome: a Cochrane review. Hum Reprod 2002; 17: 2787–94.

22. Meirow D, Fasouliotis SJ, Nugent D, et al. A laparoscopic technique for obtaining ovarian cortical biopsy specimens for fertility conservation in patients with cancer. Fertil Steril 1999; 71: 948–51.

23. Donnez J, Bassil S. Indications for cryopreservation of ovarian tissue. Hum Reprod Update 1998; 4: 248–59.

24. Oktay K. Ovarian tissue cryopreservation and transplantation: preliminary findings and implications for cancer patients. Hum Reprod Update 2001; 7: 526–34.

25. Rutherford AJ, Gosden RG. Ovarian tissue cryopreservation: a practical option? Acta Paediatr 1999; 88: 13–8.

26. Hovatta O. Methods for cryopreservation of human ovarian tissue. Reprod Biomed Online 2005; 10: 729–34.

27. Newton H, Aubard Y, Rutherford A, et al. Low temperature storage and grafting of human ovarian tissue. Hum Reprod 1996;11: 1487–91.

28. Newton H, Fisher J, Arnold JR, et al. Permeation of human ovarian tissue with cryoprotective agents in preparation for cryopreservation. Hum Reprod 1998; 13: 376–80.

29. Gook DA, Edgar DH, Borg J, et al. Oocyte maturation, follicle rupture and luteinization in human cryopreserved ovarian tissue following xenografting. Hum Reprod 2003; 18: 1772–81.

30. Candy CJ, Wood MJ, Whittingham DG. Restoration of a normal reproductive lifespan after grafting of cryopreserved mouse ovaries. Hum Reprod 2000; 15: 1300–4.

31. Almodin CG, Minguetti-Camara VC, Meister H, et al. Recovery of fertility after grafting of cryopreserved germinative tissue in female rabbits following radiotherapy. Hum Reprod 2004; 19: 1287–93.

32. Candy CJ, Wood MJ, Whittingham DG. Follicular development in cryopreserved marmoset ovarian tissue after transplantation. Hum Reprod 1995; 10: 2334–8.

33. Kim SS, Yang HW, Kang HG, et al. Quantitative assessment of ischemic tissue damage in ovarian cortical tissue with or without antioxidant (ascorbic acid) treatment. Fertil Steril 2004; 82: 679–85.

34. Oktay K, Buyuk E, Veeck L, et al. Embryo development after heterotopic transplantation of cryopreserved ovarian tissue. Lancet 2004; 363: 837–40.

35. Oktay K, Tilly J. Livebirth after cryopreserved ovarian tissue autotransplantation. Lancet 2004; 364: 2091–2; author reply 2092–3.

36. Bedaiwy MA, Falcone T. Ovarian tissue banking for cancer patients: reduction of post-transplantation ischaemic injury: intact ovary freezing and transplantation. Hum Reprod 2004; 19: 1242–4.

37. Blumenfeld Z. Preservation of fertility and ovarian function and minimalization of chemotherapy associated gonadotoxicity and premature ovarian failure: the role of inhibin-A and –B as markers. Mol Cell Endocrinol 2002; 187: 93–105.

38. Practice Committee of the American Society for Reproductive Medicine. Ovarian tissue and oocyte cryopreservation. Fertil Steril 2004; 82: 993–8.

39. Martinez-Madrid B, Dolmans MM, Van Langendockt A, et al. Freeze-thawing intact human ovary with its vascular pedicle with a passive cooling device. Fertil Steril 2004; 82: 1390–4.

40. Schilsky R, Sherins R, Hubbard S, et al. Long-term follow-up of ovarian function in women treated with MOPP chemotherapy for Hodgkinęs disease. Am J Med 1981; 71: 552–556.

41. Blumenfeld Z. Preservation of fertility and ovarian function and minimalization of chemotherapy associated gonadotoxicity and premature ovarian failure: the role of inhibin-A and –B as markers. Mol Cell Endocrinol 2002; 187: 93–105.

42. Blumendfeld Z. Fertility after treatment for Hodgkinęs disease. Ann Oncol 2002; 13(Suppl 1): 138–47.

43. Pritchard KI. GnRH analogues and ovarian ablation: their integration in the adjuvant strategy. Recent Results Cancer Res 1998; 152: 285–97.

44. Manger K, Wildt L, Kalden JR, et al. Prevention of gonadal toxicity and preservation of gonadal function and fertility in young women with systemic lupus erythematosus treated by cyclophosphamide: the PREGO-Study Autoimmun Rev 2006; 5: 269–72.

45. Mardešič T, Šnajderová M, et al. Protocol combining GnRH agonists and GnRH antagonists for rapid supression and prevention of gonadal damage during cytotoxic therapy. Eur J Gynaecol Oncol 2004; 25: 90–2.

46. Huser M, Crha I, Hudecek R, et al. Ovarian tissue cryopreservation – new opportunity to preserve fertility in female cancer patients. Eur J Gynaecol Oncol 2007; 8: 49–55. Review.

47. Huser M, Višňová H, Ventruba P, et al. Možnosti ochrany reprodukčních funkcí u žen podstupujících chemoterapii pro hematologickou malignitu. Prakt gyn 2006; 9: 6–8.

48. Huser M, Juránková E, Crha I, et al. Kryokonzervace ovariální tkáně – šance na záchranu fertility žen s nádorovým onemocněním. Čes Gynek 2007; 72: 68–73.

49. Ortin TT, Shoshlak CA, Donaldson SS. Gonadal status and reproductive function following treatmen for Hodgkinęs disease in childhood: The Stanford experience. Int J Radiol Oncol Biol Phys 1990; 19: 873–80.

50. Blumenfeld Z. Gender diference: fertility preservation in young women but not in men exposed to gonadotoxic chemotherapy.Minerva Endocrinol 2007; 32: 23–34.

51. Oh MS, Chang MS, Park W, et al. Yukmijihwang-tang protects against cyclophosphamide-induced reproductive toxicity. Reprod Toxicol 2007; 24: 365–70.

52. Selvakumar E, Prahalathan C, Sudharsan PT, et al. Chemoprotective effect of lipoic acid against cyclophosphamide-induced changes in the rat sperm. Toxicology 2006; 217: 71–8.

53. Selvakumar E, Prahalathan C, Sudharsan PT, et al. Protective effect of lipoic acid on cyclophosphamide-induced testicular toxicity. Clin Chim Acta 2006; 367: 114–9.

54. Paynter SJ. Current status of the cryopreservation of human unfertilized oocytes. Human Reprod Update 2000; 6: 449–56.

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