Reproductive Complications

Published on 04/03/2015 by admin

Filed under Hematology, Oncology and Palliative Medicine

Last modified 04/03/2015

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Chapter 60

Reproductive Complications

Summary of Key Points

• Reproductive complications resulting from cancer or its treatment are expected to increase as the number of cancer survivors increases.

• The risks of infertility related to cancer therapy and the available fertility preservation options should be discussed with all patients of reproductive age before cancer therapy begins.

• Oligospermia is present in more than 50% of patients with Hodgkin lymphoma and testicular cancer.

• Prostatectomy and other pelvic surgeries are associated with erectile dysfunction; retroperitoneal dissection is associated with retrograde ejaculation.

• Erectile dysfunction occurs within 2 years after treatment in 60% to 80% of patients with prostate cancer who are treated with external beam radiation.

• The use of sildenafil has reestablished potency in a large number of patients with surgery- or radiation-induced erectile dysfunction.

• Radiation can affect testicular spermatogenesis after doses as low as 15 cGy. Ovarian function is more resistant, but the effects are age related.

• Gonadal shielding and ovarian transposition ameliorate the effects of radiation on gonadal function.

• Gynecologic surgery can have a direct impact on sexual function by altering the normal female genital anatomy.

• Alkylating agents are associated with the highest rates of infertility in men and women.

• Doses and duration of chemotherapy agents are directly associated with the risk of infertility.

• The return of menses does not indicate preservation of ovarian function.

• Cancer complicates 1 in every 1000 pregnancies.

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