Chemotherapy Affects Fertility for Years

Chemotherapy worse on reproductive health than previously thought

(RxWiki News) Having cancer and undergoing chemotherapy as a young woman is traumatic enough. Researchers are now learning that chemotherapy can have a major impact on a woman's reproductive health - even years later.

Doctors have been painting a slightly too rosy picture about the effects of chemotherapy has on a woman's ability to have children. Researchers at the University of California, San Francisco (UCSF) have revealed a more realistic outlook that will help women and physicians better plan and prepare for what the future may hold in terms of childbearing.

"Ask for a frank estimation of the impact chemotherapy will have on your body."

In the past, amenorrhea (no menstruation) after chemotherapy has been the side effect of that's received the most attention and discussion. In this new research, scientists looked at how systemic cancer treatment can also cause infertility and early menopause.

Participants included 1,041 women between the ages of 18 and 40 who had been diagnosed with five types of cancer - leukemia, Hodgkin’s disease, non-Hodgkin lymphoma, breast cancer and gastrointestinal cancer. They were surveyed about their reproductive health and history before and after treatment.

The study found:

  • The younger a woman is when she's diagnosed, the greater her risk of having early menopause
  • Chemotherapy damages the ovaries and therefore shortens a woman's childbearing window, even if her period returns after treatment
  • Ovarian failure (menses stopping) occurred in 5-10 percent of participants
  • Women who did not have ovarian failure experienced infertility in greater numbers as they aged
  • For example, Hodgkin's disease caused infertility in 18 percent of women aged 20 and in 57 percent of women aged 35
  • Infertility is higher in cancer survivors than in the general population

Authors note that additional research is needed in order to offer women more realistic assessments of their risks, "since they could experience infertility or early menopause years to decades after treatment,” said lead author Mitchell Rosen, M.D., senior author and assistant professor in the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences.

According to the 2006 Surveillance, Epidemiology, and End Results (SEER), about 120,000 women under the age of 50 develop cancer every year in the United States.

The study is available online in the journal Cancer.

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Review Date: 
August 29, 2011