59 SIDE EFFECTS AND SYMPTOM MANAGEMENT /// CHAPTER 40 How can treatment impact my reproductive system? Chemotherapy: Most chemotherapy drugs are not very good at telling the difference between healthy cells and cancer cells. » This means cancer medicine will kill healthy cells in the process of killing cancer cells. » Follicles and oocytes are some of the healthy cells that are often killed or severely damaged by chemotherapy during treatment. » Because of this damage, you may stop having periods during treatment. This does NOT necessarily mean you are infertile. Certain types or amounts of chemotherapy drugs can cause a large number of your follicles to die. » This significantly decreases your ovarian reserve. » A low ovarian reserve can make it difficult or not possible to have a baby. » When all the follicles are lost, a person enters menopause. In some women who receive cancer treatment, this can happen earlier than usual. This can mean that a woman may enter menopause before she can have a baby. High risk to Fertility * Busulfan * Carboplatin * Carmustine (BCNU) * Chlorambucil * Cisplatin * Cyclophosphamide (Cytoxan) * Dacarbazine * Doxorubicin (Adriamycin) * Ifosfamide * Lomustine (CCNU) * Mechlorethamine * Melphalan * Procarbazine * Temozolomide Low risk to Fertility * 5-fluorouracil (5-FU) * Bleomycin * Cytarabine * Dactinomycin * Daunorubicin * Fludarabine * Gemcitabine * Idarubicin * Methotrexate * Vinblastine * Vincristine Radiation: Radiation to the brain » The hypothalamus is an area in your brain that produces hormones. » Radiation to the hypothalamus can reduce the amount of hormones your brain produces that communicate with your ovaries » This can cause your ovaries to stop developing follicles and releasing oocytes. Note: The good news is that it is possible to take pills that provide these hormones and help your body to function normally. Radiation to the ovaries » This destroys oocytes and follicles and reduces ovarian reserve. » This may harm your future fertility. Radiation to the uterus » This can cause scarring in the uterus. » Scarring can make it difficult for the uterus to carry a pregnancy to full term. Surgery: Surgery to part or all of the ovaries » Surgery may be necessary to remove all or part of an ovary. » If the second ovary remains and is not damaged by chemotherapy or radiation, your healthy remaining ovary can still mature follicles and release oocytes. It is still possible to have a biologically-related baby. » If both ovaries are removed, it is no longer possible to have a biologically-related baby. Surgery to or near the fallopian tubes, uterus, cervix or vagina » Surgery to these parts of the reproductive system can leave scarring which can make it difficult for sperm to fertilize an egg. » Scars can also make it challenging for a woman's body to carry a pregnancy to term.https://fwaya.org/