Chemotherapy-Induced Infertility: Mechanisms, Risk Factors, and Fertility Preservation Strategies in Cancer Patients

Chemotherapy remains a cornerstone of cancer treatment, effectively targeting rapidly dividing cancer cells, yet its systemic effects often extend to healthy reproductive cells, resulting in temporary or permanent infertility. This review explores the mechanisms by which chemother-apy impairs fertility in both men and women, focusing on the damage to ovarian follicles and spermatogenesis. Key factors influencing fertility outcomes include the type and dosage of chemotherapy drugs, patient age, and pre-existing reproductive health. Alkylating agents, such as cyclophosphamide, and platinum-based drugs, like cisplatin, pose the highest risk of gonad-otoxicity, while other agents exhibit milder, often reversible effects. Fertility preservation op-tions such as oocyte and embryo freezing for women, sperm banking for men, and emerging techniques like ovarian and testicular tissue cryopreservation offer hope for maintaining re-productive potential. The psychological burden of infertility and the promising yet complex role of nanoparticles in reproductive medicine are also discussed. By synthesizing current research, this review underscores the need for personalized fertility counseling and advanced preserva-tion strategies to balance cancer treatment efficacy with reproductive goals.