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Table 2 Risk of treatment-related infertility with the main anticancer therapies (modified from the original [9])

From: Cancer and fertility preservation: international recommendations from an expert meeting

Degree of risk Type of anticancer treatment
Women Men
High risk
 (>80 % risk of permanent amenorrhea in women; prolonged azoospermia in men)
-HSC transplantation with cyclophosphamide/TBI or cyclophosphamide/busulfan
-External beam radiation to a field that includes the ovaries
-CMF, CEF, CAF, TAC x 6 cycles in women ≥ 40 years
-Radiation > 2.5 Gy to testis
-Chlorambucil (1.4 g/m2)
-Cyclophosphamide (19 g/m2)
-Procarbazine (4 g/m2)
-Melphalan (140 mg/m2)
-Cisplatin (500 mg/m2)
-BCNU (1 g/m2) and CCNU (500 mg/m2)
Intermediate risk
 (40 % - 60 % risk of permanent amenorrhea in women; likelihood of azoospermia in men especially when given with other sterilizing agents)
-BEACOPP
-CMF, CEF, CAF, TAC x 6 cycles in women age 30–39
-AC x 4 cycles in women ≥ 40 years
-AC or EC x 4 → Taxanes
-Busulfan (600 mg/kg)
-Ifosfamide (42 g/m2)
-BCNU (300 mg/m2)
-Nitrogen mustard
-Actinomycin D
Low risk
 (<20 % risk of permanent amenorrhea in women; only temporary reductions in sperm counts in men especially when not given with other sterilizing agents)
-ABVD in women ≥ 32 years
-CHOP x 4–6 cycles
-CVP
-AML therapy (anthracycline/cytarabine)
-ALL therapy (multi-agent)
-CMF, CEF, CAF, TAC x 6 cycles in women ≤ 30 years
-AC x 4 cycles in women ≤ 40 years
-Carboplatin (2 g/m2)
-Doxorubicin (770 mg/m2)
-Thiotepa (400 mg/m2)
-Cytosine arabinoside (1 g/m2)
-Vinblastine (50 g/m2)
-Vincristine (8 g/m2)
Very low or no risk
 (risk of permanent amenorrhea in women; temporary reductions in sperm count in men but additive effects are possible)
-ABVD in women < 32 years
-Methotrexate
-Fluorouracil
-Vincristine
-Tamoxifen
-Amsacrine
-Bleomycin
-Dacarbazine
-Daunorubicin
-Epirubicin
-Etoposide
-Fludarabine
-Fluorouracil
−6-mercaptopurine
-Methotrexate
-Mitoxantrone,
-Thioguanine
-Prednisone
-Interferon-α
Unknown risk
 (risk of permanent amenorrhea in women; effect on sperm production in men)
-Monoclonal antibodies (trastuzumab, bevacizumab, cetuximab)
-Tyrosine kinase inhibitors (erlotinib, imatinib)
-Oxaliplatin
-Irinotecan
-Monoclonal antibodies (trastuzumab, bevacizumab, cetuximab)
-Tyrosine kinase inhibitors (erlotinib, imatinib)
-Taxanes
  1. HSC hematopoietic stem cell, TBI total body irradiation, CMF cyclophosphamide, methotrexate, fluorouracil, CEF cyclophosphamide, epirubicin, fluorouracil, CAF cyclophosphamide, doxorubicin, fluorouracil, TAC docetaxel, doxorubicin, cyclophosphamide, BEACOPP doxorubicin, belomycin, vincristine, etoposide, cyclophosphamide, procarbazine, BCNU carmustine, CCNU lomustine, AC doxorubicin, cyclophosphamide, EC epirubicin, cyclophosphamide, ABVD doxorubicin, bleomycin, vinblastin, dacarbazine, CHOP cyclophosphamide, doxorubicin, vincristine, prednisone, CVP cyclophosphamide, vincristine, prednisone, AML acute myeloid leukemia, ALL acute lymphocitic leukemia