Preclinical Approaches to the Protection of Ovarian Function

Recent advances in our understanding of the mechanisms underlying the impact of cytotoxic drugs on the ovary have opened up new directions for the protection of ovarian function from chemotherapy-induced damage. There has been parallel effort towards the development of pharmacological agents that may prevent ovarian damage at the time of treatment, which would provide significant advantages over existing fertility-preservation techniques. This chapter will review preclinical developments for the protection of the ovary during ovotoxic treatment, including agents that act on relevant apoptotic pathways, the PI3K/PTEN/Akt follicle activation pathway, the vascular system, and other potential methods of reducing chemotherapy-induced ovotoxicity. These preclinical studies continue to advance our understanding of the mechanisms and pathways involved in cytotoxic ovarian damage, thus bringing us closer to preventing chemotherapy-induced infertility.