ABSTRACT
The gonadotoxic effect of chemotherapy and radiotherapy is well established; it is dose dependent and varies according to regimens used. A reduction in follicle numbers is seen3 and the course of ovarian dysfunction is consistent with the destruction of a fixed number of follicles4. Temporary or permanent cessation of menstruation may follow therapy and a greatly elevated rate of premature menopause is found in women receiving treatment against malignancy5. Survivors of cancer in childhood have been shown to have a diminished ovarian reserve in spite of regular menstrual cycles and may have a shortened reproductive life span and early meno-
pause6. Radiotherapy causes destruction of the oocytes and reduction of the follicular reserve. Total body irradiation and high dose chemotherapy, for example before bone marrow transplantation, can be expected to destroy almost all of the oocytes in the ovaries of a female patient7,8.
