Fertility Issues
Chemotherapy
Radiation
Procreative Alternatives
Radiation therapy and chemotherapy treatments may cause temporary or permanent infertility. These side effects are related to a number of factors including
the patient's sex, age at time of treatment, the specific type and dose of
radiation therapy and/or chemotherapy, the use of single therapy or many
therapies, and length of time since treatment.
When cancer or its treatment may cause infertility or sexual dysfunction, every effort should be made to inform and educate the patient about this possibility. When the patient is a child, this can be difficult. The child may be too young to understand issues involving infertility or sexuality, or parents may choose to shield the child from these issues.
Chemotherapy
For patients receiving chemotherapy, age is an important factor and recovery
improves the longer the patient is off chemotherapy. Chemotherapy drugs that
have been shown to affect fertility include: busulfan, melphalan, cyclophosphamide, cisplatin, chlorambucil, mustine, carmustine, lomustine, vinblastine, cytarabine, and procarbazine.
Radiation
For men and women receiving radiation therapy to the abdomen or pelvis, the
amount of radiation directly to the testes or ovaries is an important factor.
In women older than 40 years, infertility may occur at lower doses of radiation. Fertility may be preserved by the use of modern radiation therapy techniques
and the use of lead shields to protect the testes. Women may undergo surgery to protect the ovaries by moving them out of the field of radiation.
Procreative Alternatives
Patients who are concerned about the effects of cancer treatment on their
ability to have children should discuss this with their doctor before
treatment. The doctor can recommend a counselor or fertility specialist who
can discuss available options and help patients and their partners through the
decision-making process. Options may include freezing sperm, eggs, or ovarian tissue before cancer treatment.
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