The effect of chemotherapy and radiotherapy on fertility

Abstract

Improvements in cancer treatment have led to increasing numbers of cancer survivors who may desire to have children. Both chemotherapy and radiotherapy can have long-term consequences on reproductive function. Chemotherapeutic agents, especially alkylating agents, are gonadotoxic. Cranial irradiation may cause hypothalamic-pituitary dysfunction and disturb the hormonal regulation of menstruation and fertility. Abdominal or pelvic irradiation has direct toxic effects on the gonads. Female cancer survivors are at risk of premature ovarian failure and adverse pregnancy outcomes. Male survivors are also at risk of subfertility or infertility. This article reviews the effects of chemotherapy and radiotherapy on fertility, pregnancy, and neonatal outcomes of cancer patients.