Abstract
There has been a significant improvement in survival rates over the last decade as
a result of advances in the treatment of cancer in children. One of the consequences
of chemotherapy may be damage to the ovarian function, which can lead to loss of fertility.
Methods of fertility protection have been developed for adult women as a result of
advances in reproductive medicine, which make the option of becoming pregnant after
surviving cancer realistic. However, only some of the methods can be used in prepubescent
girls and adolescents. In addition, a higher number of miscarriages and premature
births have been found in women who underwent pelvic radiotherapy during childhood
or adolescence and the children were more commonly growth retarded. The effects of
cancer treatment on the ovarian function and later fertility should be discussed at
the start of treatment.
Zusammenfassung
Die Krebsbehandlung bei Kindern führt zu höhen Überlebensraten. Eine der Folgen einer
Chemotherapie in der Kindheit kann eine Schädigung der Eierstocksfunktion bis zur
Infertilität sein. Durch Fortschritte in der Reproduktionsmedizin sind für erwachsene
Frauen fertilitätsprotektive Techniken entwickelt worden, die die Option einer Schwangerschaft
nach überstandener Erkrankung realistisch erscheinen lassen. Allerdings lässt sich
nur ein Teil der Maßnahmen auf präpubertäre Mädchen und Adoleszentinnen übertragen.
Allerdings fanden sich bei Frauen, die in der Kindheit oder in der Adoleszenz eine
Radiatio im Beckenbereich hatten, erhöhte Raten an Fehl- und Frühgeburten und die
Kinder waren häufiger wachstumsretardiert. Der Einfluss der Krebstherapie auf die
Eierstocksfunktion und die spätere Fruchtbarkeit sind bereits zu Therapiebeginn zu
thematisieren.
Key Words
fertility preserving methods - childhood cancer - girls - adolescents - ovarian toxicity
- fertility
Schlüsselwörter
fertilitätserhaltende Maßnahmen - Krebs in der Kindheit - Mädchen - Adoleszentinnen
- Ovartoxizität - Fertilität
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Correspondence
Dr. Barbara LawrenzMD
IVF-Department
Women's University Hospital
Tuebingen
Calwerstreet 7
72076 Tuebingen
Germany
Telefon: + 49/7071/29 82211
Fax: + 49/7071/29 2250
eMail: barbara.lawrenz@med.uni-tuebingen.de