Химиотерапевтический побочный эффект – Бесплодие


Males have testicles, or testes, as their gonads, and females have ovaries as their gonads. The function of the gonads is to produce gametes (sex cells) for reproduction and secrete sex hormones.

One of the most significant impairments of the quality of life after chemotherapy is infertility.

Males have testicles, or testes, as their gonads, and females have ovaries as their gonads. The function of the gonads is to produce gametes (sex cells) for reproduction and secrete sex hormones. In the female of the species the reproductive cells are the egg cells, and in the male the reproductive cells are the sperm.

Because these medicines travel through the blood to the entire body, chemotherapy is described as a body-wide treatment. The most common chemotherapy agents act by killing cells that divide rapidly, one of the main properties of most cancer cells.

As a result, chemotherapy may damage or kill some normal cells.

When this damage occurs, there can be Infertility, because certain chemotherapeutic drugs, may bring damage to the gonads.

Virtually all-chemotherapeutic regimens can cause male and female gonadal toxicity and are common complications of modern anti-cancer treatments

The ovaries are adversely affected by chemotherapy regimens.

Female infertility by chemotherapy appears to be secondary to premature ovarian failure by loss of primordial follicles.

Accelerated and premature depletion of germ cells in the gonads caused by direct toxic insults to the primordial follicle oocyte is the main mechanism underlying gonadal failure. In addition, damage to ovarian stroma and microvascular architecture may be contributory to this damage.

When there is a possibility of gonadal damage, methods of preserving fertility should be discussed. Where there is a partner and sufficient time, embryos can often be successfully generated and stored using in vitro fertilisation (IVF) techniques.

The age of the patient, the type and dose of chemotherapy are the main factors determining the magnitude of the damage in the ovary.

Chemotherapies with high risk include procarbazine and other alkylating drugs such as cyclophosphamide, ifosfamide, busulfan, melphalan, chlorambucil, and chlormethine. Drugs with medium risk include doxorubicin and platinum analogs such as cisplatin and carboplatin. On the other hand, therapies with low risk of gonadotoxicity include plant derivatives such as vincristine and vinblastine, antibiotics such as bleomycin and dactinomycin, and antimetabolites such as methotrexate, mercaptopurine, and 5-fluorouracil.

During puberty (usually around age 13 to 14), a boy’s testicles start making sperm, and they normally will keep doing so for the rest of his life.

Chemotherapy (chemo) works by killing cells in the body that are dividing quickly. Since sperm cells divide quickly, they are an easy target for damage by chemotherapy. Permanent infertility can result if all the immature cells in the testicles that divide to make new sperm (spermatogonial stem cells) are damaged to the point that they can no longer produce maturing sperm cells.

High dose chemotherapy treatments for cancer can cause azoospermia, absence of motile (and hence viable) sperm in the semen, which may be due to a depletion of the Spermatogonial stem cells that are at the foundation of spermatogenesis pool.

Spermatogenesis is highly sensitive to the effects of chemotherapy and irradiation and male patients should, where relevant, routinely be offered sperm banking before treatment starts. Where sperm are absent from the ejaculate, testicular sperm extraction can sometimes be successful.

Many side effects go away fairly quickly after treatment ends, but some may take months or even years to completely go away. Sometimes the side effects can last a lifetime, such as when chemo causes long-term damage to the heart, lungs, kidneys, or reproductive organs. Certain types of chemo sometimes cause delayed effects, such as a second cancer that may show up many years later.

Side effects of chemotherapy depend on many things, including the type of cancer and which drugs are being used. Each person reacts differently to these drugs. Some newer chemotherapy drugs that better target cancer cells may cause fewer or different side effects.

The time it takes to get over some side effects and get your energy back varies from person to person.

Your health care provider will explain what you can do at home to prevent or treat some chemotherapy side effects. These measures include:

Being careful with pets and other animals to avoid catching infections from them

Eating enough calories and protein to keep your weight up

Preventing bleeding, and what to do if bleeding occurs

Practicing safe eating and drinking habits

Washing your hands often with soap and water

You will need to have follow-up visits with your provider during and after chemotherapy. Blood tests and imaging tests, such as x-rays, MRI, CT, or PET scans will be done to:

Monitor how well the chemotherapy is working

Watch for damage to the heart, lungs, kidneys, blood, and other parts of the body.

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