Young adults diagnosed with cancer are living longer than ever due to improved treatment regimens. The 5-year survival rate for certain subtypes of leukemia and Hodgkin's and non-Hodgkin's diseases, for example, has dramatically increased to 75%-90%.1 However, the neoplastic disease per se and/or its treatment commonly impair fertility, leaving many patients unable to bear healthy, biological children.

Hematologic malignancies, in particular, can adversely affect fertility in a number of ways. Since these diseases generally involve the hypothalamus and pituitary, they can directly affect gonadotropin secretion, resulting in secondary hypogonadism and, hence, defective sperm formation and infertility. In addition, chemotherapy and radiation therapy—both being used to treat hematologic malignancies—are toxic to the male and female gonads. Even if fertility does not decline as a result of therapy or returns naturally, patients can still be rendered sterile by cyto-toxic therapy, as these drugs can cause genetic mutations in germ cells.2 Similarly, any cytotoxic therapy administered to pregnant women has the potential for serious teratogenic consequences on the fetus (see Chapter 106).

Pregnancy Guide

Pregnancy Guide

A Beginner's Guide to Healthy Pregnancy. If you suspect, or know, that you are pregnant, we ho pe you have already visited your doctor. Presuming that you have confirmed your suspicions and that this is your first child, or that you wish to take better care of yourself d uring pregnancy than you did during your other pregnancies; you have come to the right place.

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