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.
