Abstract
Premature ovarian failure is one of the side effects of chemotherapy in pre-menopausal cancer patients. Preservation of fertility has become increasingly important in improving the quality of life of completely recovered cancer patients. Among the possible strategies for preserving fertility such as ovarian tissue cryopreservation, co-treatment with a pharmacological adjuvant is highly effective and poses less of a burden on the human body. Melatonin is generally produced in various tissues and acts as a universally acting antioxidant in cells. Melatonin is now more widely used in various biological processes including treating insomnia and an adjuvant during chemotherapy. In this review, we summarize the information indicating that melatonin may be useful for reducing and preventing premature ovarian failure in chemotherapy-treated female patients. We also mention that many adjuvants other than melatonin are developed and used to inhibit chemotherapy-induced infertility. This information will give us novel insights on the clinical use of melatonin and other agents as fertoprotective adjuvants for female cancer patients.
Highlights
The most significant and common side effects of chemotherapy include infertility and premature ovarian failure (POF) [1]
Major international guidelines recommend that physicians should discuss with their female cancer patients at risk of chemotherapy-induced POF and ovarian dysfunction, and help with the decision of fertility preservation as early as possible [2,3,4]
We summarize the mechanisms and reports demonstrating the role of melatonin as a fertoprotective adjuvant that suppresses chemotherapy-induced dormant follicle activation and preserves the follicle reserve
Summary
The most significant and common side effects of chemotherapy include infertility and premature ovarian failure (POF) [1]. Among the strategies for preservation of fertility, cryopreservation of a piece of ovarian tissue or premature oocyte is commonly considered. These methods are limited because of several factors such as time, cost, and gonadotoxic potential attributable to storage procedures [2,4]. Many patients experience chemotherapy-induced side effects, and the need to preserve fertility has been repeatedly highlighted by physicians. In this brief review, we summarize the mechanisms and reports demonstrating the role of melatonin as a fertoprotective adjuvant that suppresses chemotherapy-induced dormant follicle activation and preserves the follicle reserve. The data suggest that melatonin could be a potential agent in the field of fertility preservation for chemotherapy-treated female cancer patients
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