Impact of Chemotherapy and Radiotherapy on the Ovary

Chemotherapy and radiation can both significantly decrease fertility potential. For chemotherapy, factors such as dose, age of patient, type of cancer, and type of drug being used are the most significant prognostic factors in determining future reproductive potential. As the dose and age of a patient increases, the chance of pregnancy decreases. Alkylating agents are the biggest culprits of decreased fertility. Some cancers that are more associated with decreased fertility potential are Hodgkin’s lymphoma and breast cancer. For radiotherapy, the most significant factors for future reproductive potential are dose and location. Radiotherapy to the ovaries is the most significant risk factor for acute ovarian failure. There is a direct inverse relationship between radiation dose and fertility potential. Considering the high cure rate of childhood cancers and the deleterious long-term effects of chemotherapy and radiation, it is important to be familiar with both the treatment options for cancer and future fertility.