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Post-chemotherapy ovarian failure — Clinical Guidelines

Overview

Post-chemotherapy ovarian failure refers to the premature cessation of ovarian function following chemotherapy, often leading to amenorrhea and infertility in affected women 1 11.

Diagnosis

Clinical assessment focusing on amenorrhea and hormonal changes (elevated FSH levels) 1.

No specific diagnostic tests highlighted; relies heavily on clinical presentation and patient history 1.

Management

Hormone replacement therapy (HRT) may be considered to manage symptoms and prevent osteoporosis 1.

Psychological support and counseling are crucial for patients facing infertility and hormonal changes 1.

Fertility preservation options, such as oocyte or embryo cryopreservation, should be discussed pre-chemotherapy if feasible 1.

Special Populations

Pregnancy: Not directly addressed in provided abstracts 1.

Pediatrics: No specific considerations mentioned 1.

Elderly: Management focuses on symptom relief and quality of life, with HRT considerations based on individual risk factors 1.

Comorbidities: Management should account for coexisting conditions, particularly cardiovascular risks with HRT 1.

Key Recommendations

Discuss fertility preservation options with patients prior to chemotherapy initiation to mitigate future reproductive concerns (Evidence: Expert opinion) 1.

Implement hormone replacement therapy cautiously, considering individual risk factors for complications such as cardiovascular disease (Evidence: Expert opinion) 1.

Provide comprehensive psychological support to address emotional impacts of ovarian failure and infertility (Evidence: Expert opinion) 1.

References

1 Herrstedt J, Clark-Snow R, Ruhlmann CH, Molassiotis A, Olver I, Rapoport BL et al.. 2023 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting. ESMO open 2024. link 2 Price M. Drug Reactions and Desensitization to Chemotherapeutic Agents: An Overview and Case Study. Clinical journal of oncology nursing 2024. link 3 Penna S. Chemotherapy-Induced Taste Alteration. Clinical journal of oncology nursing 2023. link 4 Wright F, Cooper BA, Paul SM, Hammer MJ, Conley YP, Levine JD et al.. Distinct Profiles of Morning and Evening Fatigue Co-Occurrence in Patients During Chemotherapy. Nursing research 2023. link 5 Kuo MC, Chang P. From a Suspect Victim to the Holmes: The Unexpected Value of a Home-Made Mobile Chemotherapy Medication Administration System. Studies in health technology and informatics 2016. link 6 Harrold K. Managing cytotoxic chemotherapy extravasation: use of saline washout. British journal of nursing (Mark Allen Publishing) 2015. link 7 Reeves ST, Havidich JE, Tobin DP. Conscious sedation of children with propofol is anything but conscious. Pediatrics 2004. link 8 Pourabbas E, Mucci N, Maceratini R, Rafanelli M. An information system on toxicological risks linked to drug manipulation. Studies in health technology and informatics 1999. link 9 Daly L. Safe handling of cytotoxic drugs. Australian nursing journal (July 1993) 1997. link 10 Dougherty L. Scalp cooling to prevent hair loss in chemotherapy. Professional nurse (London, England) 1996. link 11 Adams L. Managing chemotherapy-induced nausea and vomiting. Professional nurse (London, England) 1993. link 12 Baack BR, Burgdorf WH. Chemotherapy-induced acral erythema. Journal of the American Academy of Dermatology 1991. link70073-b) 13 De Campeneere D, Baurain R, Slachmuylder-Otte C, Trouet A. Immunological evaluation of blood contamination in tissue distribution studies. Pharmacological research 1989. link90117-5) 14 Krutchik AN, Buzdar AU. Pigmentation of the tongue and mucous membranes associated with cancer chemotherapy. Southern medical journal 1979. link

Post-chemotherapy ovarian failure