Cancer Treatments That Affect Fertility
CANCER AND FERTILITY
The possibility of having a biological child in the future may ease patients to go through with chemotherapy or radiation and provides a positive stimulus to recovery. Although future fertility cannot be guaranteed, the option to conceive provides a sense of hope for women at risk of becoming sterile.
A woman’s reproductive system can be damaged by the following types:
- Radiation Therapy
Regardless of the treatment, it is always important to discuss with your obstetrician about whether your body can safely handle a pregnancy.
The effects of radiotherapy and chemotherapy
Ovarian damage and failure are important and unfortunately common long-term side-effects of radiotherapy and curative chemotherapy. Sterilization and early menopause in a young female adult have a high impact on the patient’s self-esteem and quality of life. Also, patients who recover menses after chemotherapy face likelihood of premature menopause as the result of a depleted egg store.
This presents a serious problem for these cured patients, because many of them are relatively young and have exceptions of a normal reproductive life.
Bone marrow transplantation
Studies indicate that there is a extremely high risk of early menopause in female patients who undergo bone marrow transplantation. Growth and sexual development are impaired in children and sterility is common in adults.
Ovarian damage and failure are common long-term side-effects of curative chemotherapy. The risk is influenced by the patients age at treatment and the chemotherapy regimen. Late complications associated with chemotherapy, such as secondary malignancies and adverse effects on the female gonads, assume greater significance.
Partial ovarian injury
Chemotherapy and radiotherapy reduce the egg reserve in the ovary, which can trigger ovarian failure. With many young patients, cyclic menses may proceed for a number of years after treatment but they are at risk of undergoing early menopause.
Patients who regain ovarian function following high-dose chemotherapy or radiotherapy treatment should not delay child bearing. These patients should try to conceive, after few disease-free years, although not less than 6-12 months after treatment due to possible toxicity of the treatment. Of course, if it is not already late, measures to preserve fertility before chemotherapy or radiation should be done first.
Pelvic radiation has adverse effects on the ovaries at all ages. The degree and persistence of the damage depend on the dose, irradiation field and patient’s age, with older women being at greater risk of damage. The ovaries are exposed to significant doses of radiation when radiotherapy is used to treat pelvic and abdominal disease such as cervical and rectal cancer, and with craniospinal radiotherapy for malignancies of the central nervous system. Shielding of the gonads is used where possible, or the radiation field is restricted to avoid irradiation of the ovaries, but in some cases this can not be achieved.
Young women who are not sterilized by radiotherapy treatment have an increased risk of sterility and early menopause.