Chapter 20 - Effects of chemoradiotherapy for hematological malignancy on fertility and pregnancy

Summary

The chemotherapy agents and radiotherapy used to treat leukemias and lymphomas can affect reproductive potential in a variety of ways. This chapter considers the general effects of chemoradiotherapy for hematological malignancy on female fertility and the incidence of infertility following radiation and chemotherapy. The likelihood of infertility following chemotherapy depends on the drug(s) administered, the doses to which the patient is exposed, the underlying disease, and patient age. Chemotherapy agents can be divided into classes based upon their mechanism of action. There are several reasons why pregnancy outcome might be adversely affected by prior treatment with chemoradiotherapy. The chapter focuses on the relationship between chemoradiotherapy and fertility potential, effects on other maternal organs may cause complications for pregnancy and delivery. In women whose treatment is highly likely to result in infertility, cryopreservation of embryos prior to treatment offers the best hope for parenthood post-chemoradiotherapy.