Impact of Medical Treatments of Colorectal Cancer on Female Fertility and Oncofertility Issues in Young Women with Non-Metastatic Colorectal Cancer: State of the Art

Author(s): Julie Labrosse, Laurent Quero, Michael Grynberg, Gaetan des Guetz

The incidence of Colorectal Cancer (CRC) is increasing among patients of reproductive age. However, very little is known on the impact of medical treatments of CRC on fertility after cancer treatment. We aimed to discuss data existing so far relating to the gonadotoxicity of CRC treatments, fertility issues in CRC female patients of reproductive age and Fertility Preservation (FP) options in this context. We reviewed the literature to identify articles adressing the effect of CRC treatments on female fertility and oncofertility issues using databases EMBASE, the National Library of Medicine (MEDLINE)/PubMed, and the Cochrane Review Library. Studies suggest that although CRC chemotherapy might be midly toxic for ovaries, some cases of persistent amenorrhea have been reported, notably in rectal cancer patients. Pelvic radiotherapy might further impair ovarian reserve, as ovarian tissue is one of the most radiosensitive tissues. Although different FP options exist, it seems that CRC patients are not systematically addressed in FP consultations prior to systemic treatments. In all, data are scarce concerning the impact of medical treatments of CRC on female fertility. To date, in the lack of clear data, CRC patients of reproductive age should be referred to FP units to discuss FP options available.