General Health

Does Cancer Treatment Impact Fertility in a Patient?

The term “fertility” describes the capacity to conceive or have children. The ability to become pregnant through regular sexual activity and bring the child to term is referred to as female fertility. The health of one’s reproductive organs and other elements, including the timing and frequency of sex, specific hormones, and whether or not their partner has fertility issues, all affect a person’s ability to become pregnant. Infertility, sometimes known as being infertile, is the inability to conceive a child. Infertile women may not be able to become pregnant through regular sexual activity or may experience difficulties during pregnancy. If a woman hasn’t been able to have a child after 12 or more months of regular sexual activity, or after six months if she is over 35, doctors typically consider her infertile.

What affects fertility in a cancer patient?

Many cancer treatments might impact the fertility of a girl or woman. The following variables may have an impact on fertility:

  • cancer types and treatments (s)
  • your baseline fertility
  • the amount (dose) of treatment
  • your age at the time of treatment
  • and the length of time since your last cancer treatment
  • the length (duration) of treatment
  • other personal health factors

Radiation therapy eliminates cancer cells by utilizing high-energy rays. A woman’s fertility can be adversely affected by radiation directed at or near her reproductive organs.

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Radioactivity in the pelvic region

The ovaries are damaged by radiation to the point where it interferes with their ability to function. The rays can be trapped and harm the ovaries even if the radiation does not explicitly target them. The ovaries absorb a significant amount of radiation when it is focused on the vagina. The dose absorbed by the ovaries during radiation therapy for a woman’s abdominal (belly) or pelvis will decide whether she loses her ability to conceive. High amounts may result in early menopause or infertility by destroying some or all of the eggs in the ovaries.

The majority of women who get pelvic radiation lose their fertility. However, if the ovaries are shifted further away from the target area during a quick procedure to save them, which might be possible to perform before radiation starts, some eggs may survive.

Scarring brought on by radiation to the uterus can limit its flexibility and blood flow. Additionally, it prevents the uterus from expanding fully during pregnancy. These issues may prevent the uterus from developing fully during pregnancy. Premature birth, low birth weight babies, and miscarriage are all more likely among women who have had radiation to the uterus. Women who received radiation as children before the uterus started to expand throughout puberty are more likely to experience these issues.

Radiation to Brain

The pituitary gland can occasionally be impacted by radiation to the brain. Therefore, interfering with these signals might impair ovulation and the release of eggs from the ovaries. The pituitary gland ordinarily signals the ovaries to produce hormones. Depending on the radiation’s focus and dose, this may or may not impact fertility. A fetus may be harmed by radiation. When receiving radiation therapy, some females could be pregnant. It’s crucial to discuss your risk for infertility with your doctor before beginning treatment if you are fertile or believe you could be.

Chemotherapy

All of a female’s eggs are present when she is born. Until the female reaches menopause, when the hormonal cycles inevitably end, hormones allow mature eggs to be released each month throughout the menstrual cycle. Chemotherapy (also known as “chemo”) kills rapidly dividing cells in the body. The cells of the ovaries produce the hormones, such as estrogen, required to release eggs each month and prepare the uterus for a potential pregnancy (oocytes). Oocytes frequently experience chemo side effects due to their propensity for rapid division. It may result in the loss of those vital hormones and impact fertility. A woman may occasionally experience early or premature menopause.

Among the Chemo drugs that are associated with infertility in females, there are:

  • Busulfan
  • Chlorambucil
  • Carboplatin
  • Cyclophosphamide
  • Carmustine
  • Cisplatin

Higher doses of these medications are more likely to result in long-lasting reproductive problems, and drug combinations can have more of an impact. Your medication regimen and dosage play a role in determining whether your infertility is temporary or permanent.

Temporary infertility

If you are temporarily infertile, your periods may become erratic or cease while receiving therapy. However, once your treatment is over, they will return to normal—a third of all women whose periods stop due to chemotherapy experience this. Your cycles return to normal after roughly 6 to 12 months.

Permanent infertility

If you take more significant doses of the medication, permanent infertility is more probable.

Some chemotherapy medications can seriously harm the eggs in your ovaries, leaving you no eggs after treatment.

It’s crucial to avoid becoming pregnant while receiving chemotherapy if you are fertile or suspect that you could be. Many chemotherapy medications can harm an unborn child by causing birth abnormalities or other problems. A miscarriage may result from specific factors. Use highly effective birth control since some women can still become pregnant while receiving chemotherapy. Also, remember that some women can conceive even after their periods have ceased. Because of this, it’s crucial to use birth control whether or not you have periods and discuss with the team your best options.

Author

Navya Koshi

Navya Mariam Koshi is a diligent, self-motivated Pharm D graduate using this platform to leverage her skills in this field to provide excellent and exceptional health care services to the public.

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