Chapter 21 - Fertility of children exposedin uteroto chemotherapy

Summary

The effects of chemotherapy on the offsprings' gonadal function stem mainly from different reports of germ cell depletion after administration of alkylating agents in childhood cancer survivors. However, as most of these studies have focused on adults, it was unclear whether exposure to chemotherapy during early childhood and especially in utero is associated later with gonadal dysfunction. Recovery of spermatogenesis was found in some patients who received extensive chemotherapy, but it was more likely to occur after two years from the last drug therapy. The information regarding fertility of adolescents and young adults who have been exposed in utero to chemotherapy is scarce. Studies in animals have shown that rats exposed to busulfan in utero manifested sex hormone deficiencies and sterility. Chemotherapy exposure included a combination of cytarabine arabinoside and anthracyclines. All the children, including second-generation children, demonstrated normal growth and development according to height and weight developmental tables.