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Stereotactic Radiosurgery for Gynecologic Cancer
Published on: April 17, 2012
Gonadal damage from chemotherapy and radiotherapy
1Department of Endocrinology, Christie Hospital NHS Trust, Manchester, United Kingdom.
Endocrinology and Metabolism Clinics of North America
|January 29, 1999
Summary
Cancer treatments like chemotherapy and radiotherapy can cause infertility in men and women. While sperm banking is currently the only proven fertility preservation method for men, new options are emerging for both sexes.
Area of Science:
- Oncology
- Reproductive Endocrinology
- Radiation Oncology
Background:
- Cytotoxic chemotherapy and radiotherapy can cause significant gonadal damage in both men and women.
- Alkylating agents (e.g., cyclophosphamide, procarbazine) and cisplatin-based regimens are frequently implicated in treatment-related infertility.
- Radiation exposure, particularly above 2 Gy, severely impacts spermatogonia and can lead to permanent male infertility.
Purpose of the Study:
- To review the impact of cancer treatments on male and female gonadal function.
- To discuss the current and future methods for fertility preservation in cancer patients.
Main Methods:
- Review of existing literature on the effects of chemotherapy and radiotherapy on fertility.
- Analysis of data on infertility rates and recovery following cancer treatment.
- Evaluation of established and experimental fertility preservation techniques.
Main Results:
- Procarbazine regimens cause permanent infertility in most men; cisplatin leads to temporary azoospermia with partial recovery.
- Radiation doses above 0.1 Gy damage spermatogonia, with permanent infertility after 2 Gy.
- Chemotherapy causes premature ovarian failure in ~50% of women, with high-dose therapy/irradiation above 6 Gy often resulting in permanent failure.
- Ovarian function recovery is variable; ovarian transposition and tissue cryopreservation show promise.
Conclusions:
- Cancer treatments pose a significant risk to gonadal function and fertility.
- Sperm banking is the only established fertility preservation method for men.
- Ovarian transposition and future ovarian tissue cryopreservation offer potential fertility preservation strategies for women.
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