Reproductive toxicology of alkylating agents

Alkylating agents have been used during childhood and in reproductive age groups for the treatment of malignancy or collagen-vascular disease. Because of their mechanism of action, alkylating agents have the ability to interfere with chromosomal structure, ovarian function, spermatogenesis, and embryogenesis. Teratogenic risks have been established in animal studies, although are less clear for humans. Total dose, timing of administration, and age of the patient at the time of therapy are all factors in determining adverse effects. If possible, alkylating agents should be avoided in the first trimester, but can be used during the remainder of pregnancy.