Gonadal failure with cyclophosphamide therapy for lupus nephritis: advances in fertility preservation.
Intravenous cyclophosphamide remains an important therapy for patients with severe systemic lupus erythematosus--including lupus nephritis, which primarily affects women in their reproductive years. As prognosis improves, the chronic toxicity of this therapy assumes greater importance. This article reviews cyclophosphamide use, its effect on gonadal function, and protection of gonadal reserve during therapy. Egg, embryo, or gonadal tissue cryopreservation and alternative therapeutic strategies are considered.
Mersereau
Jennifer
J
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of North Carolina at Chapel Hill, CB #7570, 4001 Old Clinic Building, Chapel Hill, NC 27599-7570, USA.
Dooley
Mary Anne
MA
D000328:Adult; D000818:Animals; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D007247:Infertility, Female / Q000139:chemically induced / Q000517:prevention & control; D007248:Infertility, Male / Q000139:chemically induced / Q000517:prevention & control; D007262:Infusions, Intravenous; D008181:Lupus Nephritis / Q000188:drug therapy*; D008297:Male; D010053:Ovary / Q000187:drug effects*; D016649:Primary Ovarian Insufficiency / Q000139:chemically induced / Q000517:prevention & control; D051381:Rats; D027724:Reproductive Techniques, Assisted; D013094:Spermatozoa / Q000187:drug effects*; D055815:Young Adult
D007166:Immunosuppressive Agents; D007987:Gonadotropin-Releasing Hormone; D003520:Cyclophosphamide