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[Fertility after antimitotic treatments]
1Unité de médecine de la reproduction, hôpital Saint-Antoine, Paris, France.
Abstract:
Antimitotic chemotherapy and radiation therapy can induce temporary or permanent infertility in men, transitory amenorrhea or premature ovarian failure in women, and genetic mutations responsible of foetal deaths or congenital malformations in the progeny. Alkylating agents and radiotherapy can provoke definitive male infertility and ovarian failure, but individual susceptibility seems quite variable. In man, return of spermatogenesis can still be observed more than 10 years after treatment and pregnancies are obtained with very low sperm counts. In women, the progressive depletion of the follicular pool explains the increasing frequency of ovarian failure, with lower doses of treatment. Antimitotic and immunosuppressive therapy can also induce irreversible lesions in children's gonads.
Insights
Chemotherapy and radiation can cause infertility in men and women, and genetic mutations. Fertility may return years later, but risks to offspring remain, especially with lower treatment doses.
Area of Science:
- Reproductive medicine
- Oncology
- Genetics
Context:
- Cancer treatments like chemotherapy and radiation therapy pose significant risks to reproductive health.
- These therapies can lead to temporary or permanent infertility in both males and females.
- Genetic mutations may also occur, impacting progeny viability and development.
Purpose:
- To summarize the reproductive risks associated with antimitotic chemotherapy and radiation therapy.
- To highlight the variability in individual susceptibility to these gonadotoxic effects.
- To discuss the long-term consequences for fertility and offspring health.
Summary:
- Antimitotic chemotherapy and radiation therapy can cause male infertility and female ovarian failure, with variable individual susceptibility.
- Spermatogenesis may recover in men over a decade, enabling pregnancies with low sperm counts.
- Women face increasing ovarian failure risk with lower doses due to follicular pool depletion; children's gonads can also be irreversibly damaged.
Impact:
- Informs patients and clinicians about the reproductive side effects of cancer treatments.
- Highlights the need for fertility preservation strategies in oncology.
- Underscores the importance of understanding long-term reproductive outcomes and genetic risks for survivors and their offspring.