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 |