Radiation‑induced impacts on female fertility and fecundity: perspectives from the viewpoint of radiation protection.

Abstract

Purpose: This mini-review aims to synthesize current knowledge regarding radiation-induced effects on female fertility and reproductive capacity, and to identify knowledge gaps relevant to radiation protection.

Methods: We critically examined evidence from developmental biology, animal models, clinical studies, and epidemiological investigations. Key topics include germ cell and follicle biology, radiation dose thresholds, therapeutic exposures, and environmental and occupational contexts.

Results: Female germ cells are highly radiosensitive, with animal models indicating a mean lethal dose as low as 0.05-0.15 Gy in primordial oocytes. In humans, pelvic irradiation increases risks of acute ovarian failure, premature ovarian insufficiency, and infertility, depending on dose and age at exposure. Cranial irradiation further impairs fertility through damage to the hypothalamic-pituitary axis. In contrast, evidence from occupational and environmental exposures is scarce, with most studies addressing miscarriage or perinatal outcomes rather than infertility itself.

Conclusions: While advances in oncofertility research have clarified therapeutic risks, systematic data on environmental and occupational exposures are lacking. Strengthened prospective studies and integration of fertility-specific biomarkers are urgently needed to inform comprehensive radiation protection strategies.