The influence of radiation on fertility in man

Abstract

Increasing numbers of young people are now being cured of certain neoplasms by radiotherapy and chemotherapy. Such people will naturally wish to lead a normal life and possibly to have children. Therefore the question of the effect of radiation and cytotoxic drugs on the reproductive capacity of these patients has become important. The purpose of this report is to review the information available on the effect of radiation on fertility in man. Direct information on radiation effects on human fertility is available from reports on therapeutic exposure and deliberate experimental exposure. Although the total number of cases involved is small, a number of general principles emerge. In males, fractionated irradiation of the testes may be more harmful than acute, at least up to total doses of about 600 cGy (rad). Fractionated doses greater than 35 cGy cause aspermia, the time taken for recovery increasing with dose, and after more than 200 cGy aspermia may be permanent. In females, response varies with age as well as dose. For example, 400 cGy may cause a 30% incidence of sterility in young women, but in women aged above 40 years it results in 100% sterility. However, individuals of either sex show a degree of variation in their response to irradiation.

Effect of childhood cancer treatment on fertility markers in adult male long‐term survivors

“…Total body-and testicular irradiation causes severe gonadal dysfunction [28][29][30], which is illustrated by the fact that eight out of 10 survivors treated with TBI had almost undetectable Inhibin B levels ( 26 ng/L). In addition, local radiotherapy to the testis was administered in five men who all showed extremely low Inhibin B levels.…”

Fertility Preservation in Reproductive-Age Women Facing Gonadotoxic Treatments

“…Like chemotherapy agents, ionizing radiation has an impact on the female reproductive tract that is related to age at exposure and effective dose (fractionation schedule) 35,36 . Abdominopelvic irradiation can lead to high rates of premature ovarian failure, with even less than 2 Gy causing loss of more than 50% of the primordial follicle pool 37,38 .…”

Hypogonadism After Childhood Cancer Treatment

“…However, when ovarian transposition is performed prior to RT, ovarian function is retained in the majority of young girls and adolescent females (Ortin et al 1990, Sklar 1999, Thibaud www.intechopen.com et al 1992). In women over 40 years of age radiation dose of 400 to 700 cGy is sufficient for the sterilization, in younger women the dose from 1250 to 1500 cGy is necessary for sterilization (Ash 1980), and for those treated at the age of 10 years or less even dose of 2000 cGy is necessary for permanent ovarian damage (Lushbaugh & Casarett 1976, Sanders et al 1991, Wallace et al 2005). Nevertheless doses of less than 1000 cGy are capable of inducing ovarian damage in patients who have additional risk factors, such as concomitant exposure to alkylating agents and older age at diagnosis.…”