EHA Library - The official digital education library of European Hematology Association (EHA)

The effects of chemotherapy and radiotherapy on reproduction
EHA Library. Wallace W. 06/14/17; 185040 Topic: 4Ab Short and long term complications of chemotherapy and radiotherapy
William Hamish Wallace
William Hamish Wallace
Contributions
Learning Objectives
Drow Meirow - Chair Introduction

The advances in cancer therapy over the past decades have led to remarkable improvements in survival rates especially in childhood hematological cancer. This has resulted in a dramatic increase in the number of young adults experiencing late effects of treatment, among them premature ovarian insufficiency, testicular dysfunction and loss of fertility in both males and females are of major importance. It is highly important to understand the effects of different cancer treatment modalities on the gonads (ovaries and testes) and reproduction. At diagnosis, all patients should be consulted on the threat of compromising their fertility with planned cancer treatment. However, today only a small fraction of patients are actually referred to specialists to discuss the different options available to preserve fertility.
This education module will focus on the effects of chemotherapy and radiotherapy on female and male reproductive system, in order to increase awareness among medical health care professionals and patients. The different options available to preserve fertility in females will be presented, advantages, method selections and outcome results will be discussed. In adult males, sperm freezing is well established, however there is no clinical solution for prepubertal boys at present. The current ongoing research for this population will be presented and discussed.

Learning Objectives of the manuscript
After viewing this presentation the participant will be able to:
- To provide current evidence for impaired testicular and ovarian function after chemotherapy and radiation.
- To present the effects of pelvic radiotherapy on the uterus.
- Fertility preservation options should be discussed with all young women having to face gonadotoxic treatment.
- To study and better understand the different available modalities to preserve fertility in women– oocyte, embryo and ovarian tissue cryopreservation.
- Semen cryopreservation for future use is effective in post-pubertal men, however, Fertility preservation in prepubertal males remains experimental.
- To present the current research is focused on developing in-vitro and in-vivo strategies to preserve fertility for childhood cancer survivors.

Learning Objectives of the presentation
After viewing this presentation the participant will be able to:
- More high quality research is required to provide the evidence for impaired testicular and ovarian function after chemotherapy and radiation.
- Conditioning treatments for BMT that include chemotherapy and or radiotherapy are likely to impair gonadal function irrespective of the age of the patient at treatment.
- Radiotherapy to a field that includes the pelvis in females may impair uterine function with increased risk of miscarriage and preterm delivery.

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