Interpretation of the guidelines for the prevention, treatment and clinical management of iatrogenic premature ovarian insufficiency in clinical practice

doi:10.3969/j.issn.1006-7795.2026.04.001

Abstract

Abstract: With continuous progress a comprehensive analysis in the diagnosis and treatment of malignancies and refractory diseases, long-term survival rates have improved significantly. However, iatrogenic premature ovarian insufficiency (POI) induced by chemotherapy, radiotherapy, and pelvic surgery has become a critical issue affecting the whole-life-cycle health of female survivors. Based on the latest evidence-based medical data, this article presents a comprehensive analysis of the Practice Guideline for the Treatment and Management of Iatrogenic Premature Ovarian Insufficiency (2025) and the Practice Guideline on Ovarian Tissue Cryopreservation and Transplantation in the Prevention and Treatment of Iatrogenic Premature Ovarian Insufficiency. Both guidelines emphasize that the prevention and management of iatrogenic POI should be integrated throughout the entire course of diagnosis and treatment. Ovarian tissue cryopreservation has emerged as a promising fertility preservation strategy and is currently the only option for preserving ovarian function and fertility in prepubertal girls and reproductive-aged women who cannot delay chemotherapy or radiotherapy. Gonadotropin-releasing hormone agonists (GnRHa) cannot replace established fertility preservation techniques. International guidelines currently endorse slow freezing as the standard method for ovarian tissue cryopreservation, while vitrification is still regarded as an experimental clinical procedure. Clinicians should inform patients or their guardians of the risks of infertility and ovarian insufficiency as early as possible before initiating cancer treatment, recommend consultation on fertility preservation, and arrange timely referrals. Once POI occurs, early diagnosis, hormone-based comprehensive treatment, and long-term management are essential to reduce long-term all-cause mortality in affected patients.

Key words: iatrogenic premature ovarian insufficiency, fertility preservation, ovarian tissue cryopreservation, hormone therapy, informed consent, guideline interpretation

CLC Number:

Zhang Mingzhen, Ruan Xiangyan, Gu Muqing, Du Juan, Cheng Jiaojiao, Alfred O. Mueck. Interpretation of the guidelines for the prevention, treatment and clinical management of iatrogenic premature ovarian insufficiency in clinical practice[J]. Journal of Capital Medical University, doi: 10.3969/j.issn.1006-7795.2026.04.001.

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