Chemotherapy regimens offer hope for infertility management in women

Emobileclinic Researchers Corner

 

 

The Journal of Human Reproduction has published the findings of researchers from University of Edinburgh, United Kingdom who found that common chemotherapy drug combination lead to the growth of small eggs in women and as such suggest that this may offer hope to infertile women.

The team reviewed ovarian tissue samples of 14 women who had received chemotherapy treatment and 12 healthy women. While it is difficult to conclude if a woman is likely to be fertile following chemotherapy treatment, however, damage to eggs and fertility depend largely on the age of the woman, the types of drug and the drug doses.

The study focuses on a combination of chemotherapy drugs known as ABVD (adriamycin, bleomycin, vinblastine and dacarbazine) mostly used to treat Hodgkin’s lymphoma (HL) which is an uncommon cancer of the lymphatic system.

ABVD is one of a few known chemotherapy regimens with no negative effect on women’s fertility. The team sought to investigate this further by examining the follicles in the ovarian tissue of treated patients. The team got ovarian biopsies from 13 HL patients (six adolescent and seven adults) and one non-HL patient.
Two of the HL patients and the non-HL patient had received no treatment before biopsy collection while the other 11 patients (all HL) had undergone one or two chemotherapy treatments before biopsy sampling (eight of them receiving ABVD, the others receiving another combination therapy).

The researchers reviewed the tissue samples and compared them with ovarian tissue from age-matched healthy women. Furthermore, they examined the developmental potential of follicles by culturing some of the patients’ tissue samples for 6 days. The chemotherapy patients had donated their tissue as part of a procedure for freezing their ovaries for fertility preservation. The healthy patients had donated their tissue while undergoing cesarean section.

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The results revealed that tissue from eight of the HL patients treated with ABVD had increased concentration of non-growing follicles or immature eggs, compared with tissue from age-similar healthy women or the patients treated with a different chemotherapy combination.
The team observes that the ovary tissue in the ABVD-treated samples also seemed to be in a healthy condition – similar to that seen in tissue from the ovaries of young women.

The results further reveal that follicle growth in the cultured samples occurred in all groups, but development to the secondary stage was highly restricted in the samples from women treated with ABVD. Also, samples from untreated HL patients grow in a similar way to samples from healthy women.

The team recommends that the findings should be considered with caution, because although they reviewed a large number of follicles, the data came from a small number of biopsies from only a few patients. Nevertheless, the results were consistent and could be far-reaching.

The study raises several questions. For instance, does the fact the ABVD chemotherapy appears to increase follicle density in ovarian tissue mean that it could increase the number of mature eggs?

“We need to know more about how this drug combination acts on the ovaries, and the implications of this.”

Source:

M.Mclaughlin et.al (2016): Non-growing follicle density is increased following adriamycin, bloemycin, vinblastine ad dacarbazine (ABVD) chemotherapy in the adult human ovary. Human Reproduction. Doi:10.1093/humrep/dew260



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