We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
from SECTION 2 - Fertility Issues and Paediatric Cancers
Published online by Cambridge University Press: 05 October 2014
Introduction
Cancer in childhood is rare, with approximately 1400 new cases per year in the UK and a cumulative risk of around 1 in 500 by the age of 15 years. With long-term survival rates approaching 73%, it has been estimated that, by the year 2010, about 1 in 715 of the adult population will be a long-term survivor of childhood cancer. With improved survival there is a real focus on improving our understanding of the late adverse effects associated with successful treatment. Impaired fertility in both males and females and adverse pregnancy outcomes following successful treatment of cancer in childhood are the subject of this chapter.
Normal ovarian function
In the human ovary, the oogonia that arise from primordial germ cells in the yolk sac reach a maximum complement of 6—7 million by the sixth month of gestation. This represents the total fixed number of germ cells available. Primordial follicles consist of a primary oocyte surrounded by a single layer of spindle-shaped cells. The numbers of germ cells decline in vivo such that there are approximately 2 million primordial follicles present at birth. By a process of continuing apoptosis and attrition, approximately 400 000 primordial follicles are present at the time of menarche. The number continues to decline steadily throughout life. The ‘fertile window’ in females is characterised by roughly 400 monthly ovulations of a mature oocyte.
To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Find out more about the Kindle Personal Document Service.
To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.
To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.
