Are some chemotherapy regimens less risky to my fertility than others?

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OncoFertility (Organization (Verified) ) - 05 / 08 / 2012

Yes. Alkylating chemotherapies, such as cyclophosphamide, busulfan, procarbazine and melaphan, put women at high-risk for fertility loss after cancer. Alkylating agents can damage the resting pool of immature follicle, called the ovarian reserve, which may cause immediate infertility or premature infertility in women and girls. In contrast, nonalkylating chemotherapies such as vincristine, methotrexate and bleomycin, are less likely to cause permanent infertility in younger patients.

In addition to chemotherapy, radiation and surgical cancer treatments may cause infertility in young cancer survivors. Radiation to the pelvis, abdomen, or whole-body radiation put women at particularly high risk for later infertility by damaging the ovaries and uterus, as well as the blood supply to these organs. High levels of cranial irradiation can also impact future fertility since the brain directs much of the precise hormonal signaling required for fertility. Finally, surgeries of the abdomen and pelvis may affect fertility or the ability for a woman to carry a pregnancy to term.
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