Ovarian microenvironment: challenges and opportunities in protecting against chemotherapy-associated ovarian damage

作者：Yican Guo, Liru Xue, Weicheng Tang, Jiaqiang Xiong, Dan Chen, Yun Dai, Chuqing Wu, Simin Wei, Jun Dai, Meng Wu, Shixuan Wang · 发表于：Human Reproduction Update · 年份：2024 · DOI：10.1093/humupd/dmae020 · 被引用次数：114 · 研究领域：Reproductive Biology and Fertility、Ovarian cancer diagnosis and treatment、Cancer Risks and Factors

BACKGROUND: Chemotherapy-associated ovarian damage (CAOD) is one of the most feared short- and long-term side effects of anticancer treatment in premenopausal women. Accumulating detailed data show that different chemotherapy regimens can lead to disturbance of ovarian hormone levels, reduced or lost fertility, and an increased risk of early menopause. Previous studies have often focused on the direct effects of chemotherapeutic drugs on ovarian follicles, such as direct DNA damage-mediated apoptotic death and primordial follicle burnout. Emerging evidence has revealed an imbalance in the ovarian microenvironment during chemotherapy. The ovarian microenvironment provides nutritional support and transportation of signals that stimulate the growth and development of follicles, ovulation, and corpus luteum formation. The close interaction between the ovarian microenvironment and follicles can determine ovarian function. Therefore, designing novel and precise strategies to manipulate the ovarian microenvironment may be a new strategy to protect ovarian function during chemotherapy. OBJECTIVE AND RATIONALE: This review details the changes that occur in the ovarian microenvironment during chemotherapy and emphasizes the importance of developing new therapeutics that protect ovarian function by targeting the ovarian microenvironment during chemotherapy. SEARCH METHODS: A comprehensive review of the literature was performed by searching PubMed up to April 2024. Search terms included ...