Effects of Chemotherapy on Fertility in Men and Women

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EFFECTS OF CHEMOTHERAPY ON FERTILITY

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A man or a woman who is undergoing chemotherapy as a form of treatment will want to know if chemotherapy or cancer and cancer treatment can affect their fertility levels, especially when they are planning for a family. For successful conception, a healthy body (and mind) is a must, but cancer and cancer treatment can have some side effects in both men and women.

In this article, we will be discussing how chemotherapy affects fertility in males and females, and how a couple can plan for a baby while fighting this disease.

How Does Chemotherapy Affect Male Fertility?

Chemotherapy and male fertility do have a strong link between them and their effects can be observed no matter what the age of the person might be.

  • The sperm production in a man begins right around the age of 12 or 14 when puberty strikes and it continues unabated. If a child suffers from cancer early in life and is exposed to its treatment, the sperm production ability could take a hit, resulting in his testicles failing to produce sperm at all.
  • This is usually a result of chemotherapy. Since sperm cells divide rapidly within the body, they are quite vulnerable to be targeted by the chemicals and be destroyed.
  • A similar risk is also posed by men who are past the age of 40. Chemotherapy affects sperm production severely and results in extreme difficulty to recover the previous fertility back again. It can be due to using a specific chemotherapy drug, or even a higher dosage.
  • After the impact on sperm production, the return to fertility can take anywhere from 1 year to 10 years, once chemotherapy has completed. However, the chances of restoration to fertility are quite low if it doesn’t happen after 4 years or so.

What Can Men Do If They Want To Have a Baby After Chemotherapy?

Since chemotherapy affects sperm production when the treatment begins, it is necessary to safeguard your sperms before proceeding with it. This is where sperm banking comes into play and can help you get your own child.

  • Similar to the concept of sperm donation, sperm banking involves collecting your own sperms and storing them to be used later by you, for conceiving a child through various fertilization techniques.
  • This initially requires conducting certain medical tests to rule out the presence of any diseases such as HIV or hepatitis. Then, numerous sperm samples are procured over the course of a couple of weeks, frozen, and stored safely to be used at a later time.
  • Whenever you decide to have a child, you can get your sperm unfrozen, and use a variety of techniques, right from insemination to IVF to any other method, to fertilize an egg and proceed with the pregnancy.

SPERM BANKING

Sperm banking may not always be a possibility if you already have a low sperm count or need to commence chemotherapy right away, due to the severity of cancer.

How Does Chemotherapy Affect Fertility in Females?

Any kind of external medical treatment has known to affect the various processes and aspects of a woman, which could impact her capability to get pregnant.

  • Even before chemotherapy, if cancer in question has spread to areas of the body that are essential for pregnancy, then chemotherapy could affect these in ways that reduce the possibility to house a child within the body.
  • Chemotherapy does tend to attack the eggs that are produced by the ovary. As much as this varies from the medication used and the dosage prescribed, this effect is quite evident in women.
  • Younger women have a better chance of restoring their fertility after treatment since their egg production is quite substantial. This starts reducing rapidly as women get older and making it more difficult to get pregnant. At the same time, if pre-pubescent girls or extremely young girls are exposed to chemotherapy, they could have early menopause, making them infertile altogether.
  • Chemotherapy may harm the eggs and reduce fertility but there is a chance of it being restored once chemotherapy stops. However, if the damage is to the reproductive organs, then it could result in the production of improper eggs that fail to fertilize no matter what.

How Can Women Keep Their Fertility?

Maintaining fertility for women is a little complicated as compared to men. There are a few techniques that you can opt for, which have to be executed before beginning with the chemotherapy treatment.

1. Preservation of Ovarian Tissue

The tissue that is present in the ovaries is susceptible to harm due to chemotherapy. There has been some research conducted on a technique, which can retrieve the ovarian tissue before the treatment begins, and preserve it by means of freezing. At the end of the treatment, the tissue can be replaced back inside the woman and, if it does function just as before, the egg production can resume normally and bring back her fertility.

There are very few places that could offer such a sophisticated option and the cost-effectiveness might be a challenge, too.

2. Preservation of Eggs

This technique is well-known among most women and is usually opted for in various fertility treatment clinics as well. Eggs are the first step required to have a successful conception and it makes sense to store them until needed. With a process similar to that conducted during in-vitro fertilization, certain medicines are given to the woman to accelerate the production of eggs. These are retrieved, frozen, and stored until the time you choose to have a baby.

EGG CELL PRESERVATION

3. Preservation of Embryos

This is a step ahead of egg preservation. Such a technique is usually adopted by married couples to have a baby later at the time of choosing.

Instead of storing eggs or sperm separately, eggs are procured from the woman’s body in a similar process as above. These are then exposed to the sperms of the partner, allowing them to get fertilized in a controlled environment. Once embryos are formed with successful fertilization, they are then frozen and stored. When you are ready to have a baby, the embryos will be unfrozen and implanted within your uterus, initiating the pregnancy.

Chemo Drugs That Have Higher Risks of Causing Infertility

There are some drugs used in chemotherapy that affect certain bodily processes or organs with such severity that they significantly reduce the fertility in a person, as well as decrease the chances of its return.

Drugs That Affect Both Sperm and Egg

Here are a few drugs that affect both men and women equally, causing problems in sperm and egg production.

  • Busulfan
  • Carboplatin
  • Carmustine
  • Chlorambucil
  • Cisplatin
  • Cyclophosphamide
  • Ifosfamide
  • Lomustine
  • Melphalan
  • Procarbazine

Drugs That Affect Only Sperm

Among numerous drugs that are used for therapy, there are a few that specifically affect the sperms within a man, causing infertility to set in.

  • Actinomycin D
  • Cytarabine
  • Nitrogen mustard (mechlorethamine)
  • Procarbazine

Drugs That Affect Only Egg

Women face a higher risk of infertility due to chemotherapy and a few drugs are extremely harmful on those lines.

  • Dacarbazine
  • Doxorubicin
  • Mechlorethamine
  • Procarbazine
  • Temozolomide

CHEMOTHERAPY DRUGS

Chemo Drugs That Have Lower Risks of Causing Infertility

With chemotherapy and fertility being interdependent so intimately, there do exist a few drugs that are beneficial in treating cancer, as well as tend to offer minimal risks of infertility.

Drugs That Affect Both Sperm and Egg

These drugs are known to pose a low risk of infertility to both men and women while treating their cancer.

  • 5-Fluorouracil
  • Bleomycin
  • Cytarabine
  • Daunorubicin
  • Fludarabine
  • Methotrexate

Drugs That Affect Only Sperm

A few more drugs are available for chemotherapy that pose the lowest risk of damage to sperms in men.

  • 6-Mercaptopurine
  • Dacarbazine
  • Epirubicin
  • Etoposide
  • Mitoxantrone
  • Thioguanine

Drugs That Affect Only Egg

Along with drugs that are beneficial for both genders, a few drugs are especially beneficial for women in this regard.

  • Dactinomycin
  • Gemcitabine
  • Idarubicin

How Long Should Women Wait to Get Pregnant After Chemotherapy?

When thinking about conception after chemotherapy, there is a major consensus among doctors that women should ideally wait for a couple of years before attempting to get pregnant. This window period is essential to detect whether or not cancer cells grow again.

CONCEPTION AFTER CHEMOTHERAPY

What If a Woman Gets Pregnant While Having Chemotherapy?

Getting pregnant after chemotherapy is one thing, but undergoing chemotherapy while you are pregnant is completely different.

Depending on the type of cancer, the treatment will be decided. It could be delayed until the baby’s delivery, but most doctors don’t recommend it. Breast cancer or other types of cancer can be treated after the first trimester.

Usually, doctors might recommend terminating the pregnancy if it has just commenced, or undergoing a premature delivery if it is close to completion.

With the question – does chemotherapy affect fertility – answered in numerous ways, it is important to make the right decision regarding your life. Taking preemptive steps to safeguard your fertility before commencing treatment can be quite beneficial, and lead you to experience the joys of parenthood, without the worries of treating a severe disease.

Also Read:

Home Remedies to Boost Fertility in Men and Women
Herbs To Increase Fertility
Fertility Supplements Which Help To Conceive

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