{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:27:19Z","timestamp":1792081639344,"version":"4.4.0"},"reference-count":42,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":74,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Reprod Med"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Radiotherapy is an effective treatment for various cancers, but it can cause significant side effects on various organ systems, including the reproductive organs, which is a major concern for women of reproductive age. A well-known long-term effect of oncological treatment is premature ovarian insufficiency. Another critical but sometimes overlooked organ at risk in female cancer survivors is the uterus. This review focuses on the impact of radiotherapy on uterine physiology, highlighting key issues such as the development of fibrosis and loss of elasticity, vascular damage, and hormonal disruption, all of which can compromise uterine function. These changes can negatively impact fertility and pregnancy outcomes, such as miscarriage, preterm birth, and low birth weight. Limited evidence is also available suggesting that radiotherapy may affect endometrial receptivity and contribute to abnormal placentation. We conclude by discussing strategies aimed at mitigating the damage caused by radiotherapy, such as fertility-preserving treatments and hormonal interventions. A thorough understanding of these effects is essential for healthcare providers to offer informed support to women who wish to maintain their fertility and have children following cancer treatment.<\/jats:p>","DOI":"10.1055\/s-0045-1809040","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T20:11:18Z","timestamp":1747253478000},"page":"016-022","source":"Crossref","is-referenced-by-count":6,"title":["The Impact of Radiotherapy on the Uterus and Its Implications for Pregnancy"],"prefix":"10.1055","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0497-3814","authenticated-orcid":false,"given":"Anne-Lotte L.F.","family":"van der Kooi","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"van Dorp","sequence":"additional","affiliation":[{"name":"Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"issue":"11","key":"ref1","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1056\/NEJMra1608986","article-title":"Recent developments in radiotherapy","volume":"377","author":"D E Citrin","year":"2017","journal-title":"N Engl J Med"},{"issue":"28","key":"ref2","doi-asserted-by":"crossref","first-page":"3440","DOI":"10.1200\/JCO.2015.64.3288","article-title":"Recommendations for premature ovarian insufficiency surveillance for female survivors of childhood, adolescent, and young adult cancer: a report from the International Late Effects of Childhood Cancer Guideline Harmonization Group in Collaboration with the PanCareSurFup Consortium","volume":"34","author":"W van Dorp","year":"2016","journal-title":"J Clin Oncol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.critrevonc.2018.06.012","article-title":"Ionizing radiation-induced cellular senescence promotes tissue fibrosis after radiotherapy. 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