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Immune Checkpoint Inhibitors Impact Fertility: A Review
Iram Shabir1, Christina Foster1
1Department of Hematology/Oncology, McFarland Clinic Ames, Iowa, USA.
Abstract:
Immune checkpoint inhibitor therapy has become the established method of treatment for various types of cancers, consequently introducing a spectrum of side effects referred to as immune- mediated adverse events, affecting almost every organ, including the reproductive system. Moreover, very little clinical data is available that suggests the detrimental effect of immune checkpoint inhibitor therapy on fertility, sexual health, or potential pregnancies. In this manuscript, we reviewed the impact of immunotherapy on male and female fertility and its effect on sexual health. Patients undergoing systemic treatment with immunotherapy often experience sexual dysfunction, decreased sexual drive, erectile dysfunction, and a decline in vaginal lubrication. Fertility-desiring patients who do not receive adequate counseling may ultimately face a higher likelihood of developing anxiety, depression, and a decreased quality of life post-treatment. Therefore, it is crucial to address the reproductive consequences of planned treatment, disseminate knowledge about novel treatments and preventive measures for reproductive side effects, and provide guidance on fertility preservation. Individuals experiencing secondary reproductive dysfunction due to the tumor or its treatment should receive proactive treatment for the underlying condition and be offered hormone replacement therapy.
Insights
Immune checkpoint inhibitors can impact fertility and sexual health. Discussing reproductive risks and preservation options is crucial for cancer patients undergoing immunotherapy.
Area of Science:
- Oncology
- Reproductive Endocrinology
- Immunology
Background:
- Immune checkpoint inhibitor (ICI) therapy is a cornerstone in cancer treatment.
- ICI therapy can cause immune-mediated adverse events affecting multiple organs, including the reproductive system.
- Limited clinical data exists on ICI's impact on fertility, sexual health, and pregnancy outcomes.
Purpose of the Study:
- To review the effects of immunotherapy on male and female fertility.
- To examine the impact of immunotherapy on sexual health.
- To highlight the importance of fertility preservation and counseling for cancer patients.
Main Methods:
- Literature review of studies on immunotherapy's reproductive and sexual side effects.
- Analysis of clinical data regarding fertility and sexual health outcomes in patients treated with ICIs.
- Synthesis of information on managing reproductive dysfunction associated with cancer treatment.
Main Results:
- ICI therapy is associated with sexual dysfunction, including decreased libido, erectile dysfunction, and reduced vaginal lubrication.
- Patients undergoing immunotherapy may experience psychological distress, such as anxiety and depression, if not adequately counseled on reproductive risks.
- Fertility-desiring patients require comprehensive counseling and proactive management strategies.
Conclusions:
- Addressing the reproductive consequences of ICI therapy is essential.
- Disseminating knowledge on novel treatments and preventive measures for reproductive side effects is critical.
- Fertility preservation options and hormone replacement therapy should be offered to affected individuals.
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