Clinical Assessment of Ovarian Toxicity

Research output: Chapter in Book/Report/Conference proceedingChapter


Chemotherapy and radiotherapy have long been recognized to cause ovarian toxicity, manifesting clinically as amenorrhoea during treatment, and premature ovarian insufficiency (POI) with loss of fertility. While POI can be readily diagnosed biochemically, it is clear that many women treated for cancer have a reduced ovarian reserve, underpinning the risk of later early menopause. Recent years have seen much exploration of biomarkers of this, particularly serum anti-Müllerian hormone and ultrasound-determined antral follicle count. This has allowed clear demonstration of reduced numbers of growing follicles in these women, indicating partial loss of the ovarian reserve, i.e., primordial follicle pool, although this cannot be determined directly. Relationships with treatment regimens have been determined, and pretreatment with anti-Müllerian hormone has been shown to predict long-term ovarian activity, though not fertility. Ovarian reserve can also be measured in prepubertal girls, thus allowing investigation of gonadotoxicity with consequences for the need for pubertal induction and likely reproductive lifespan, although that remains to be clearly shown in long-term studies.

Original languageEnglish
Title of host publicationCancer Treatment and the Ovary: Clinical and Laboratory Analysis of Ovarian Toxicity
PublisherElsevier North-Holland, Inc.
Number of pages11
ISBN (Print)9780128016015, 9780128015919
Publication statusPublished - 1 Sep 2015


  • Anti-Müllerian hormone
  • Antral follicle count
  • Chemotherapy
  • Infertility
  • Ovarian reserve
  • Premature ovarian insufficiency

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