How does bone marrow transplantation affect ovarian function and fertility?

Purpose of review This article sets out to review the literature on gonadal toxicity of bone marrow transplantation (BMT) in women, and preventive and curative actions available for girls and women facing BMT and infertility. Findings The real incidence of ovarian damage after BMT is difficult to assess. Series reporting ovarian function and pregnancies after BMT vary greatly in terms of endpoints, number of patients included, age at and indications for BMT, conditioning regimens and duration of follow-up. The risk of premature ovarian failure (POF) is very high, however, and increases with age and in case of BMT conditioning treatment with total body irradiation. Embryo, oocyte and ovarian cortex cryopreservation are effective fertility preservation methods that should be discussed with all girls and young women requiring BMT. Summary Despite a lack of literature on long-term follow-up of fertility after BMT in large populations, it is clear that the risk of ovarian damage and POF is very high. Fertility preservation options should therefore be discussed with all patients having to undergo BMT.