[Hypogonadism and alkylating agents (author's transl)]

Area of Science:

• Oncology
• Reproductive Toxicology
• Pharmacology

Background:

• Alkylating agents are widely used in chemotherapy across various medical specialties.
• Increasing efficacy and survival rates necessitate evaluating long-term side effects, including gonadal toxicity.
• Reproductive risks associated with alkylating agents require careful consideration, especially for non-life-threatening indications.

Observation:

• The gonads are susceptible to early and insidious damage from alkylating agents, preceding other side effects.
• Testicular toxicity appears more pronounced than ovarian toxicity.
• Male gonadal damage is influenced by pubertal status and may be dose or duration-dependent, with poor recovery chances.

Findings:

• Alkylating agents pose significant risks to reproductive function.
• Testicular damage is more severe and less likely to recover compared to ovarian damage.
• Ovarian resistance is noted, but teratogenic risks necessitate contraception during and after treatment.

Implications:

• Oncologists and prescribers must counsel patients on potential infertility risks associated with alkylating agents.
• Fertility preservation strategies, such as sperm banking, are crucial for male patients.
• Contraceptive measures are essential for female patients due to teratogenic risks and potential ovarian damage.