Abstract: Surgical resection, radiotherapy and chemotherapy are the current mainstays of cancer treatments. During ovarian cystectomy, part of the normal ovarian cortex could be resected together with ovarian mass, which compromises ovarian reserve postoperatively. This reduction in ovarian reserve is especially pronounced after resection of ovarian endometriomas. On the other hand, radiotherapy and chemotherapy may cause apoptosis of the component cells, diminish blood supply in the ovaries and weaken the brake on follicular recruitment. Brought together, these mechanisms give rise to accelerated deprivation of ovarian follicles, and hence undermine fecundity of the affected individuals. Moreover, radiotherapy could result in alterations in structure and functions of uterus and other pelvic organs, which translate into increased incidence of obstetric complications later on. Currently antral follicular count and serum anti-Müllerian hormone are the most sensitive and accurate measurements of ovarian reserve.

Key words: Neoplasms, Fertility, Surgical procedures, operative, Drug therapy, Radiotherapy