Hemin Reserves Ovarian Function by Estrogen Receptor Up-Regulation in Chemotherapy-Induced Ovarian Failure

Background: Breast cancer exhibits the highest rate of cancer incidence in women worldwide and in South Korea, and approximately 47% of breast cancer patients in South Korea are premenopausal women. The childbirth rate in breast cancer survivors is low compared to the non-breast cancer control group, and concerns about childbirth upon breast cancer treatment are also high. Chemotherapy-induced ovarian damage varies according to the patient's age and type of chemotherapeutic agent. Cisplatin is a platinum agent that attacks the primordial and primary follicles to reduce the ovarian reserve. The available options for ovarian functional preservation include cryopreservation of ovarian tissues, oocytes, or embryos before breast cancer treatment, which, however, are invasive as they require surgery and may delay breast cancer treatment due to the time taken for the collection of oocytes or embryos. Therefore, this study investigated the effects of hemin as a potential agent for ovarian functional preservation.