The influence of used drugs on hormonal and gonadal function, and the resulting diminished gonadal reserve or premature gonadal failure, are heavily entwined with cancer treatment-related infertility problems. While germ cell preservation recommendations are primarily focused on preventing cause infertility, they do not take into account earlier chemotherapeutic exposures that could result in genetic alteration, potentially leading to congenital abnormalities. This exploratory analysis is being presented in order to improve recognition of agents and exposures that should be identified during oncofertility assessment in order to prevent gamete preservation. The results of an original study analysing the established pharmacokinetics and mutagenic toxicities of conventional chemotherapy were compared to the rates at which such medicines were administered during a 23-week period. A significant 54 percent of the investigated agents (and related metabolites) were found to be mutagenic; analysis of the agent distribution pattern revealed mutagenic exposures in more than one-third of the treated child-bearing population, accounting for 27 percent of the total study patient population. Because more than half of conventional chemotherapeutics have the ability to modify the DNA of oocytes and sperm, past exposures to mutagenic chemotherapeutics should be investigated. If exposure is proven, gamete preservation may be prohibited due to an increased risk of genetic mutation, which could result in both physical and mental birth abnormalities. The necessity to examine newly emerging oncologic drugs for mutagenic/clastogenic potential, as well as the identification of such exposures in reproductive-age cancer patients, profoundly modifies the present approach to fertility preservation.
Author(S) Details
Nicole L. Longo, DO, FACOI
Board-certified in Internal Medicine, USA.
View Book:- https://stm.bookpi.org/IDMMR-V6/article/view/5599
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