The effects of cancer treatments on uterine function

Advancements in cancer treatments and associated increased survival rates have led to a growing number of girls and women facing reproductive health challenges as a result of their oncologic treatments. Radiation and chemotherapy have been demonstrated to have adverse effects on fertility. Ovarian damage as a result of radiation and chemotherapy has been the subject of extensive study. Less well understood are the uterine changes mediated by these treatment modalities. Uterine damage from radiation therapy is related to dose, regimen, and patient age. Certain chemotherapies have demonstrated similar effects. Women with uterine damage have a lower likelihood of conceiving and a higher risk of pregnancy complications, including early pregnancy loss, preterm labor, and low birth weight infants. Surgical, medical, and genetic therapies are being evaluated to protect the uterus from treatment-related injury. Pre- and post-treatment consultation with oncofertility specialists is critical in assessing a patient's risk of uterine injury from a proposed cancer treatment plan as well as understanding treatment-induced injury to optimize fertility preservation.