How ovaries are the canary in the coalmine of women's health - and need further focus in clinical trials

Our ovaries are the “canaries in the coalmine” of women’s health; as well as fertility, healthy ovaries are linked to a healthy heart, strong bones and warding off dementia in old age. Yet clinical trials into treatments for diseases like cancer often do not take into consideration the impact on ovarian health. Professor Karla Hutt from Monash University’s Biomedicine Discovery Institute wants to change that.

We all know that we are born with a finite number of eggs and that these reduce in number and robustness until we reach menopause. But we are less aware of the ovaries’ sensitivity to environmental toxicants and medications, according to Professor Hutt.

“We need to not only focus more on protecting our ovaries, across the entire lifespan, but we must also study how they are impacted by things like cancer treatment,” she said.

Professor Hutt, who is a member of the Monash Women’s Health Alliance, and her research team have developed a series of mouse models that can rapidly and accurately test the impact of cancer treatments on ovarian health. She has found that checkpoint inhibitors, new cancer drugs that help the immune system find and kill cancer cells, unexpectedly led to a reduction in the number of eggs and in the health of those remaining in mice.

Last year Professor Hutt was a co-author on a landmark statement published in The Lancet Oncology that showed that – despite anticancer agents known to impair ovarian function, resulting in premature menopause and associated long-term health effects – ovarian toxicity is not usually adequately assessed in trials of anticancer agents.

The statement – led by the American Society of Clinical Oncology (ASCO) – called for incorporation of ovarian toxicity measures in clinical trial design. “Cancer is just one area where the effect of drugs and therapies on ovarian health in women has been neglected,” Professor Hutt said. “This needs to change.”

In early August, the National Health and Medical Research Council (NHMRC) released a statement encouraging sex, gender, variations of sex characteristics and sexual orientation to be routinely considered in health and medical research.

The NHMRC is the largest public funder of health and medical research in Australia and distributes hundreds of millions of dollars in research grants every year, including through the Medical Research Future Fund (MRFF).

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