Reproductive risks associated with exposure to antineoplastic agents: a review of the literature

Health care professionals of child-bearing age are greatly concerned about the potential reproductive risks posed by occupational exposure to antineoplastic agents. Many antineoplastic agents are known mutagens and teratogens, and occupational exposure is likely if precautions are not observed. Animal data on teratogenicity may not be applicable to humans. Data on therapeutic exposure to these drugs indicate that pregnant women are most susceptible to fetal loss and teratogenic effects during the first trimester. Recently published retrospective studies indicate the same may be true for occupational exposure to antineoplastic agents. Women exposed at other times should not be at risk. Based on data from animal studies and therapeutic exposure of male patients, occupational exposure of men to these agents should not pose any significant risk. Observing published guidelines for safe handling of antineoplastic agents has been shown to minimize exposure and should thereby greatly decrease any potential reproductive risk. Nevertheless, pregnant women should avoid occupational exposure to antineoplastic agents during the first trimester of pregnancy.