<p>Chemotherapy-induced reproductive toxicity remains a formidable off-target consequence of anticancer regimens, creating a critical barrier to the preservation of ovarian endocrine and gametogenic function in female patients. This review dissects the molecular and cellular cascades that underpin chemotherapy-driven ovarian insult—including DNA double-strand breaks, mitochondrial depolarization, accelerated primordial follicle activation, and oxidative stress—and critically evaluates emerging cytoprotective modalities. By synthesizing current mechanistic insights with pre-clinical and early-phase clinical data, we outline innovative strategies poised to mitigate ovarian damage without compromising oncological efficacy.</p> Graphical Abstract <p></p>

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Fertility under fire: how chemotherapy harms the ovaries and the science fighting back?

  • Jingyi Zhou,
  • Donghai Zhang,
  • Yongsheng Yu,
  • Qian Zhou

摘要

Chemotherapy-induced reproductive toxicity remains a formidable off-target consequence of anticancer regimens, creating a critical barrier to the preservation of ovarian endocrine and gametogenic function in female patients. This review dissects the molecular and cellular cascades that underpin chemotherapy-driven ovarian insult—including DNA double-strand breaks, mitochondrial depolarization, accelerated primordial follicle activation, and oxidative stress—and critically evaluates emerging cytoprotective modalities. By synthesizing current mechanistic insights with pre-clinical and early-phase clinical data, we outline innovative strategies poised to mitigate ovarian damage without compromising oncological efficacy.

Graphical Abstract