Chapter 60 • 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.
Reproductive Complications
Summary of Key Points
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Reproductive Complications
