title: Effect of first line cancer treatment on the ovarian reserve and follicular density in girls under the age of 18 years.
abstract: OBJECTIVE
  To study the impact of first-line antineoplastic treatment on ovarian reserve in young girls returning for ovarian tissue cryopreservation (OTC) in connection with a relapse.
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  University hospitals.
  
  
  METHODS
  Sixty-three girls under the age of 18 years who underwent OTC before (group 1: 31 patients) and after (group 2: 32 patients) their initial cancer treatment.
  
  
  METHODS
  None.
  
  
  METHODS
  Follicular densities (follicles/mm3) measured from an ovarian cortical biopsy before OTC. The ovarian volume (mL) of entire ovaries excised for OTC was also monitored.
  
  
  RESULTS
  There was no statistically significant difference in the mean age or follicular density between groups 1 and 2 (334 ± 476/mm3vs. 327 ± 756/mm3). In contrast, the ovarian volume and total number of ovarian cortex chips cryopreserved were statistically significantly lower in patients who received gonadotoxic treatment before OTC (mean ± standard deviation [SD]: ovarian volume, 5.3 ± 3.1 mL vs. 2.9 ± 2.1 mL, respectively; number of cortex chips: 21.3 ± 8.1 vs. 15.2 ± 7.1, respectively). The reduction in the estimated ovarian reserve ranged from 10% to 20% in children to around 30% in adolescent girls (>10 years).
  
  
  CONCLUSIONS
  Girls under the age of 10 tolerate a gonadotoxic insult better than adolescents, who may experience up to a 30% reduction in the ovarian reserve via first-line gonadotoxic treatment, which at present is considered to have little effect on the follicle pool. This information will improve counseling of young female cancer patients in deciding whether to undergo fertility preservation treatment.
authors.affiliation: Laboratory of Reproductive Biology, Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Meryam
authors.initials: M
authors.lastname: El Issaoui
authors.affiliation: Laboratory of Reproductive Biology, Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Veronica
authors.initials: V
authors.lastname: Giorgione
authors.affiliation: Laboratory of Reproductive Biology, Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Linn S
authors.initials: LS
authors.lastname: Mamsen
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Juliane Marie Centre, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Catherine
authors.initials: C
authors.lastname: Rechnitzer
authors.affiliation: Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Birkebæk
authors.affiliation: Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Clausen
authors.affiliation: School of Computer Science, University of St. Andrews, St. Andrews, United Kingdom.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Kelsey
authors.affiliation: Laboratory of Reproductive Biology, Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. Electronic address: yding@rh.dk.
authors.forename: Claus Yding
authors.initials: CY
authors.lastname: Andersen
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D015925:Cryopreservation; D003718:Denmark; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D006801:Humans; D007223:Infant; D006080:Ovarian Follicle / Q000187:drug effects* / Q000473:pathology; D065851:Ovarian Reserve / Q000187:drug effects*; D010053:Ovary / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents
keywords: Fertility preservation; follicle density; ovarian tissue cryopreservation; ovarian volume