Review: Influence of Radiation on Female Fertility and Pregnancy
Kirkuk University Journal-Scientific Studies,
2021, Volume 16, Issue 2, Pages 1-23
AbstractRadiations made up of non-ionizing and ionizing radiations, this classification is based on the ionizing power and the energy of radiations. In developed and developing communities, people are continually exposed to radiations which are generated from variety sources that are naturally occurring or producing by human. The purpose of this study is to review accessible information on the influence of radiation on female fertility and to discuss the options for fertility preservation. Radiation exposure can result in impairment of tissue integrity and sometimes, leading to organs dysfunction, the impact of radiations on organs depends on site of irradiation, patient age and total radiation dose. Female patients who are treated with radiation have an increased rate of uterine dysfunction, ovaries dysfunction, impaired fertility, incidence of pregnancy complications, premature birth and miscarriage. Pre-pubertal uterus is more vulnerable to the effect of radiation, compared with the pubertal uterus due to arising ovarian estrogen production and uterus enlarges. To reduce the effects of radiations on female reproductive organ, fertility preservation procedures such as ovarian transposition, reproductive gland protection and oocyte cryopreservation should be carried out before and/or during radiotherapy.
 E. M. Zeman, E. C. Schreiber, J. E. Tepper. " In Abeloff's Clinical Oncology", 6th Ed., Elsevier, Carolina (2020).
 F. M. Khan, J. Gibbons. Khan's, "the physics of radiation therapy", 4th Ed.,Lippincott Williams & Wilkins, USA (2014).
 R. Marci, M. Mallozzi, L. Di Benedetto, M. Schimberni, S. Mossa, I. Soave, S. Palomba, Caserta D., "Radiations and female fertility", Reproductive Biology and Endocrinology. 16 (2), 21 (2018)
 United Nations Scientific Committee on the Effects of Atomic Radiation, "Sources, effects and risks of ionizing radiation" ,1st Ed., United nation, New York (1989).
 J. Shapiro. "Radiation protection", 1st Ed., Harvard University Press; Cambridge, MA United State Harvard University Press, Garden St., Cambridge, (1990).
 A. I. Kassis, "Therapeutic radionuclides: biophysical and radiobiologic principles", In Seminars in nuclear medicine, 38(5), 366 (2008).
 M. L. Annunziata, " Radioactivity Introduction and History", 1st Edi., Elsevier Science, London (2007).
 WHO, IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, "X-radiation and γ-radiation? In Ionizing Radiation, Part 1: X-and Gamma (γ)-Radiation, and Neutrons". 1st Ed., International Agency for Research on Cancer, Lyon (2000).
 E. B. Podgorsak, "Radiation oncology physics: a handbook for teachers and students", 3rd Ed., International Atomic Energy Agency, London (2008).
 Mehta K.,"Radiation basic principles", Journal of vascular surgery, 42(6),1237 (2005).
 J. Juutilainen. "Developmental effects of electromagnetic fields", Bioelectromagnetics, 26 (7), 115 (2005).
 M. C. Gye, C. J. Park. "Effect of electromagnetic field exposure on the reproductive system", Clinical and experimental reproductive medicine, 39(1), 24 (2012).
 A. Zamanian, C. J. Hardiman, "Electromagnetic radiation and human health", A review of sources and effects. High Frequency Electronics, 4(3), 26 (2005).
 N. G. K. H. "Non-ionizing radiations–sources, biological effects, emissions and exposures", the international conference on non-ionizing radiation, Uniten, ICNIR, 20, 16 (2003)
 N. F. A. Bakar, S. A. Othman, N. F. A. N. Azman, and N. S. Jasrin, "Effect of ionizing radiation towards human health", Earth and Environmental Science, 268(2), 201 (2019).
 E. L. Bohm, J. Hendry, R. Hill, J. Le Heron, K. Mishra, K. Trott, J. Wondergem. "Radiation Biology: A Handbook for Teachers and Students. ", 1st Ed., International Atomic Energy Agency, Vienna (2010).
 E. B. Podgorsak, K. Kainz. "Radiation oncology physics: A handbook for teachers and students. "2nd Ed., International Atomic Energy Agency, London (2006).
 R. Baskar, K. A. Lee, R. Yeo, K. W. Yeoh. "Cancer and radiation therapy: current advances and future directions", International journal of medical sciences, 9(3), 196 (2012).
 A. C. Begg, F. A. Stewart, C. Vens. "Strategies to improve radiotherapy with targeted drugs",Nature Reviews Cancer, 11(4), 253 (2011).
 P. P. Connell, S. Hellman. "Advances in radiotherapy and implications for the next century: a historical perspective", Cancer research, 69(15), 392 (2009).
 S. Gianfaldoni, R. Gianfaldoni, U. Wollina, J. Lotti, G. Tchernev, T. Lotti. "An overview on radiotherapy: from its history to its current applications in dermatology ", Open access Macedonian journal of medical sciences, 25(4), 528 (2017).
 L. A. Bishop, K.S. Richter, G. Patounakis, L. Andriani, K. Moon, K. Devine. "Diminished ovarian reserve as measured by means of baseline follicle-stimulating hormone and antral follicle count is not associated with pregnancy loss in younger in vitro fertilization patients", Fertility and Sterility, 108(6), 987 (2017).
 J. Sia, R. Szmyd, E. Hau, H. E. Gee. "Molecular mechanisms of Radiation-Induced cancer cell death: a primer", Frontiers in cell and developmental biology, 8(1), 41 (2020).
 J. Y. Wo, A. N. Viswanathan. "Impact of radiotherapy on fertility, pregnancy, and neonatal outcomes in female cancer patients", International Journal of Radiation Oncology* Biology* Physics, 73(5), 1312(2009).
 AL. Ogilvy-Stuart, S. M. Shalet. "Effect of radiation on the human reproductive system", Environmental health perspectives, 101(2), 116(1993).
 W. H. Wallace, A. B. Thomson, T. W. Kelsey. "The radiosensitivity of the human oocyte", Human reproduction, 18(2), 121 (2003).
 WH. Wallace, AB Thomson, F. Saran, TW. Kelsey. "Predicting age of ovarian failure after radiation to a field that includes the ovaries", International Journal of Radiation Oncology* Biology* Physics, 3(63), 744 (2005).
 W. H. Wallace, S. M. Shalet, E. C. Crowne, P. H. Morris-Jones, H. R. Gattamaneni. "Ovarian failure following abdominal irradiation in childhood: natural history and prognosis", Clinical oncology, 2(1), 99 (1989).
 L. E. Bath, G. Tydeman, H.O. Critchley, R. A. Anderson, D. T. Baird, W. H. Wallace, "Spontaneous conception in a young woman who had ovarian cortical tissue cryopreserved before chemotherapy and radiotherapy for a Ewing's sarcoma of the pelvis: case report", Human Reproduction, 11(19), 2572 (2004).
 Piek M.W., Postma E. L., van Leeuwaarde R., de Boer J. P., Bos A. M., Lok C., Stokkel M., Filipe M. D., van der Ploeg IM, "The effect of radioactive iodine therapy on ovarian function and fertility in female thyroid cancer patients: a systematic review and meta-analysis", Thyroid, 31(4), 668(2020).
 E. M. Mantawy, R. S. Said, and A. K. Abdel-Aziz, "Mechanistic approach of the inhibitory effect of chrysin on inflammatory and apoptotic events implicated in radiation-induced premature ovarian failure: Emphasis on TGF-β/MAPKs signaling pathway", Biomedicine & Pharmacotherapy, 1(109), 303 (2019).
 Y. F. Mahran, A. M. Badr, A. Aldosari, R. Bin-Zaid, and H. N. Alotaibi, "Carvacrol and Thymol Modulate the Cross-Talk between TNF-α and IGF-1 Signaling in Radiotherapy-Induced Ovarian Failure", Oxidative medicine and cellular longevity, (2019).
 Y. H. Haddad, R. S. Said, R. Kamel, E. M. El Morsy, and E. El-Demerdash, "Phytoestrogen genistein hinders ovarian oxidative damage and apoptotic cell death-induced by ionizing radiation: co-operative role of ER-β, TGF-β, and FOXL-2", Scientific Reports, 10(1), 13(2020).
 H. O. Critchley, W. H. Wallace, S. M. Shalet, H. Mamtora, J. Higginson, D. C. Anderson. "Abdominal irradiation in childhood; the potential for pregnancy. BJOG", An International Journal of Obstetrics & Gynaecology, 5(99), 394 (1992).
 K. Holm, E. Mosfeldt, V. Brocks, J. Müller, "Pubertal maturation of the internal genitalia: an ultrasound evaluation of 166 healthy girls. Ultrasound in Obstetrics and Gynecology", The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 3(6), 181 (1995).
 N. A. Bridges, A. Cooke, M. J. Healy, P. C. Hindmarsh, Brook C. G., "Growth of the uterus", Archives of disease in childhood, 4(75), 331 (1996).
 R. A. Lobo. "Potential options for preservation of fertility in women", New England Journal of Medicine, 1 (353), 73 (2005).
 B. Simon, S. J. Lee, A. H. Partridge, C. D. Runowicz. "Preserving fertility after cancer. CA", a cancer journal for clinicians, 55(4), 228 (2005).
 E. M. Laursen, K. Holm, V. Brocks, M. Jarden, J. Müller. "Doppler assessment of flow velocity in the uterine artery during pubertal maturation. Ultrasound in Obstetrics and Gynecology", The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology, 53(8), 45 (1996).
 K. Holm, K. Nysom, V. Brocks, H. Hertz, N. Jacobsen, J. Müller. "Ultrasound B-mode changes in the uterus and ovaries and Doppler changes in the uterus after total body irradiation and allogeneic bone marrow transplantation in childhood", Bone marrow transplantation, 3(23), 263 (1999).
 H. O. Critchley, L. E. Bath, W. H. Wallace. "Radiation damage to the uterus—review of the effects of treatment of childhood cancer", Human Fertility, 2 (5) , 66 (2002).
 E. C. Larsen, K. Schmiegelow, C. Rechnitzer, A. Loft, J. Müller, A. N. Andersen "Radiotherapy at a young age reduces uterine volume of childhood cancer survivors" Acta obstetricia et gynecologica Scandinavica, 1(83), 102 (2004).
 W. T. Teh, C. Stern, S. Chander, and M. Hickey, "The impact of uterine radiation on subsequent fertility and pregnancy outcomes", Radiation Oncology and Medical Physics, 4(6), 52 (2014).
 B. Buonomo, R. Orecchia, F. Tomao, L. Del Pup, A. Garcia-Faura, F. A. Peccatori "Uterine irradiation as a determinant of infertility and pregnancy losses in young cancer survivors", cancer medical science, 4(9), 14 (2020).
 M. J. Griffiths, A. L. Winship, and K. J. Hutt, "Do cancer therapies damage the uterus and compromise fertility", Human reproduction update, 26(2), 173 (2020).
 M. Ali, & N. Ficus hispida Linn Chaudhary, "A review of its pharmacognostic and ethnomedicinal properties", Pharmacognosy Reviews, 5(9), 96 (2011).
 R. A. Cowles, R. M. Gewanter, J. J. Kandel. "Ovarian repositioning in pediatric cancer patients: Flexible techniques accommodate pelvic radiation fields", Pediatric Blood & Cancer, 3(49), 341(2007).
 A. M. Chiarelli, L. D. Marrett, G. A. Darlington. "Pregnancy outcomes in females after treatment for childhood cancer", Epidemiology, 11(2), 166 (2000).
 Li. FPE, K. Gimbrere, RD. Gelber, SE. Sallan, F. Flamant, DM. Green DM, RM. Heyn, Meadows AT. "Outcome of pregnancy in survivors of Wilms' tumor",JAMA network cancer, 2(9) , 219 (1987).
 Byrne J., Mulvihill J. J., Connelly R. R., Austin D. A., Holmes G. E., Holmes F. F., Latourette H. B., Meigs J. W., Strong L. C., Myers M. H., "Reproductive problems and birth defects in survivors of Wilms' tumor and their relatives", Medical and pediatric oncology, 16 (4), 34 (1988).
 J. F. Winther, J. D. Boice, AL. Svendsen, K. Frederiksen, M. Stovall, J. H. Olsen."Spontaneous abortion in a Danish population-based cohort of childhood cancer survivors", Journal of Clinical Oncology, 26(10) , 40 (2008).
 E. R. Norwitz, H. M. Stern, H. Grier, A. Lee-Parritz. "Placenta percreta and uterine rupture associated with prior whole body radiation therapy", Obstetrics & Gynecology, 98(5), 931 (2001).
 L. Arrive, Y. C. Chang, H. Hricak, R. J. Brescia, W. Auffermann, Quivey J. M. "Radiation-induced uterine changes: MR imaging", Radiology, 1(170), 88 (1989).
 D. Green, J. A. Whitton, M. Stovall, A. C. Mertens, S. S. Donaldson, F. B. Ruymann, T. W. Pendergrass, L. Robison. "Pregnancy outcome of female survivors of childhood cancer: a report from the Childhood Cancer Survivor Study", American journal of obstetrics and gynecology, 4(187), 1080 (2002).
 D. M Green. "Preserving fertility in children treated for cancer: Preventing the effects of radiation and chemotherapy on gonadal function ", British medical journal, 323(732), 1201 (2005).
 I. C. Ann. International Commission on Radiological Protection (ICRP). "Pregnancy and medical radiation: ICRP Publication", Ann International Commission on Radiological Protection, 30(84), 43 (2000).
 M. De Santis, E. Cesari, E. Nobili, G. Straface, AF. Cavaliere, A. Caruso, " Birth Defects Research Part C: Embryo Today: Reviews",Radiation effects on development, 3(81), 182 (2004).
 M. M. Hawkins, G. J. Draper, R. A. Smith. "Cancer among 1,348 offspring of survivors of childhood cancer", International journal of cancer, 6 (43) , 897 (1989).
 F. P. Li, W. Fine, N. Jaffe N, G. E. Holmes, F. F. Holmes, "Offspring of patients treated for cancer in childhood",Journal of the National Cancer Institute, 5 (62), 1197 (1979).
 E. C. Larsen, A. Loft, K. Holm, J. Muller, V. Brocks, A. N. Andersen. "Oocyte donation in women cured of cancer with bone marrow transplantation including total body irradiation in adolescence", Human Reproduction, 7(15), 1508 (2001).
 M. M. Hudson, "Reproductive outcomes for survivors of childhood cancer", Obstetrics and gynecology, 5(116) ,1171 (2010).
 R. A. Anderson, W. H. Wallace. "Fertility preservation in girls and young women",Clinical endocrinology, 75(4), 419 (2011)
 K. A. Rodriguez-Wallberg, K. Oktay. "Fertility preservation during cancer treatment: clinical guidelines", Cancer management and research, 1(6) , 105 (2014).
 J. A. Kalapurakal, S. Peterson, EM. Peabody, P. R. Thomas, D. M. Green, G. J. D’angio, NE. Breslow. "Pregnancy outcomes after abdominal irradiation that included or excluded the pelvis in childhood Wilms tumor survivors: a report from the National Wilms Tumor Study", International Journal of Radiation Oncology* Biology* Physics, 58(5), 1368 (2004).
 L. R. Schover, L. A. Rybicki, B. A. Martin, K. A. Bringelsen. "Having children after cancer: A pilot survey of survivors' attitudes and experiences", Cancer, 86(4), 709 (1999).
 P. Ghadjar, V. Budach, C. Köhler, A. Jantke, S. Marnitz. "Modern radiation therapy and potential fertility preservation strategies in patients with cervical cancer undergoing chemoradiation", Radiation Oncology, 2(105), 98 (2015).
 J. Stachecki and J. Cohen, "An overview of oocyte cryopreservation", Reproductive BioMedicine Online, 9 (2) 163 (2004).
 E. Porcu, A. Bazzocchi, L. Notarangelo, R. Paradisi, C. Landolfo and S. Venturoli, "Human oocyte cryopreservation in infertility and oncology", Current Opinion in Endocrinology, Diabetes and Obesity, 15(6), 35 (2008).
 T. Falcone and M. Bedaiwy, "Fertility preservation and pregnancy outcome after malignancy", Current Opinion in Obstetrics and Gynecology, 17(1), 26 (2005).
 P. Morice, L. Juncker, A. Rey, J. El-Hassan, C. Haie-Meder and D. Castaigne, "Ovarian transposition for patients with cervical carcinoma treated by radiosurgical combination", Fertility and Sterility, 74(4), 748 (2000).
 J. Classe et al., "Ovarian transposition by laparoscopy before radiotherapy in the treatment of hodgkin's disease", Cancer, 83(7), 1424 (1998)
 K. Žilinskas, Ž. Sabonytė-Balšaitienė and N. Samalavičius, "Laparoscopic ovarian transposition in patients with pelvic cancer", Acta medica Lituanica, 20(4), (2014).
 L. Turkgeldi, A. Cutner, E. Turkgeldi, A. Al Chami, A. Cassoni, N. Macdonald, T. Mould, A. Nichol, A. Olaitan, E. Saridogan. " Laparoscopic Ovarian Transposition and Ovariopexy for Fertility Preservation in Patients Treated with Pelvic Radiotherapy with or without Chemotherapy", Facts, Views & Vision in Obgyn. 3 (11), 245 (2019)
 E. J. Hoekman, D. Knoester, A. A. Peters, F. W. Jansen, de C. D. Kroon, & C. G. Hilders, "Ovarian survival after pelvic radiation: transposition until the age of 35 years", Archives of gynecology and obstetrics, 5 (298), 1007 (2018).
 L. Xu, F. Q. SUN, & Z. H. WANG, Radical trachelectomy versus radical hysterectomy for the treatment of early cervical cancer: a systematic review", Acta obstetricia et gynecologica Scandinavica, 11 (90), 1209 (2011).
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