Reproductive health care in female cancer patients
1. A woman's fertility
In the mid-40s to mid-50s, women experience changes in hormone levels that stop the release of eggs and stop menstruating. This is called menopause.
Some cancer treatments can also affect the ovaries and cause early menopause.
2. Can cancer treatment affect fertility?
The main methods to treat cancer today are chemotherapy, radiation therapy, surgery, endocrine therapy and targeted therapy. These methods are used in combination to treat different types of cancer and can also affect fertility due to:
Effects on eggs and ovaries. Affects hormone production. Change or remove the uterus. In some cases, it's a good idea to see an obstetrician-gynecologist prior to cancer treatment to discuss future pregnancies (preserving fertility). In some cases, however, preserving fertility is virtually impossible. One of those situations is when you need immediate cancer treatment (emergency chemotherapy, emergency surgery, ...) or because the cancer itself affects fertility.
After cancer treatment, if you intend to have children but have not been able to conceive for 6 months, you should check your fertility.
3. Does cancer treatment affect quality of sex life?
Usually, you don't need to stop having sex during chemotherapy. However, if you have thrombocytopenia or leukopenia, you should temporarily not have sex until your blood test results improve.
Chemicals can cause abnormalities on the development of the fetus; Therefore, you need to use birth control during treatment until a few months after chemotherapy. You should also not breastfeed your baby during this time.
In addition, you should use a condom during sex during chemotherapy days as well as until a few days after finishing chemotherapy to protect your husband or boyfriend because chemicals can appear in your vaginal discharge.
4. How can chemotherapy for cancer affect fertility?
The risk of infertility often depends on:
Age: The chances of getting pregnant after 35 years of age in women will be lower than in younger women because the number and quality of eggs begin to decrease and menopause is easier. In young women, after chemotherapy, if menstruation is restored, menopause will also occur 5 to 10 years earlier than usual. Chemotherapy drugs: Some chemotherapy drugs, such as cyclophosphamide and chlorambucil, have a higher risk of infertility than others, such as doxorubicin and cisplatin (moderate risk) or vincristine and methotrexate (risk) low or no risk of infertility). Dosage: The higher the dose of chemotherapy drugs, the greater the effect on fertility.
5. Can radiation therapy affect fertility?
Radiation therapy to the pelvis: Radiotherapy directly to the uterus or ovaries will cause permanent infertility. Radiation therapy to the pelvis can also cause indirect damage to the uterus or ovaries and increase the risk of infertility, miscarriage, or premature birth if the lining of the uterus is damaged.
The risk of infertility also depends on the dose of radiation and your age. The older you are, the higher your risk of infertility. The risk of infertility is higher if you have recently received a combination of radiation and chemotherapy.
Whole-body radiation: Whole-body radiation is often used before a stem cell or bone marrow transplant. This method often causes permanent infertility.
Radiation therapy to the brain: Radiation therapy to the pituitary gland of the brain can have an effect on fertility because the pituitary gland releases the hormone gonadotrophin to cause the ovaries to produce estrogen and progesterone. If the pituitary gland is affected, the ovaries will not be stimulated to secrete sex hormones and cause infertility. In this case, you may be given an injection of gonadotropin to help you potentially get pregnant.
Radiation therapy to other areas of the body will not usually cause infertility.
6. Will surgery affect fertility?
7. Can hormone therapy or targeted drugs cause infertility?
Targeted therapy may also have effects on fertility, but the mechanism is unknown. Of these, only one drug, bevacizumab (Avastin®), is known to increase infertility.
Để đặt lịch khám tại viện, Quý khách vui lòng bấm số HOTLINE hoặc đặt lịch trực tiếp TẠI ĐÂY. Tải và đặt lịch khám tự động trên ứng dụng MyVinmec để quản lý, theo dõi lịch và đặt hẹn mọi lúc mọi nơi ngay trên ứng dụng.