Fertility under fire: how chemotherapy harms the ovaries and the science fighting back?

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Chemotherapy-induced reproductive toxicity remains a formidable off-target consequence of anticancer regimens, creating a critical barrier to the preservation of ovarian endocrine and gametogenic function in female patients. This review dissects the molecular and cellular cascades that underpin chemotherapy-driven ovarian insult—including DNA double-strand breaks, mitochondrial depolarization, accelerated primordial follicle activation, and oxidative stress—and critically evaluates emerging cytoprotective modalities. By synthesizing current mechanistic insights with pre-clinical and early-phase clinical data, we outline innovative strategies poised to mitigate ovarian damage without compromising oncological efficacy.

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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