From the Guidelines
For leukemia patients undergoing chemotherapy who wish to preserve fertility, sperm banking is recommended for males and egg/embryo freezing for females before starting treatment, as soon as possible after diagnosis but before beginning chemotherapy, as many chemotherapeutic agents can damage reproductive cells. This approach is crucial because while many patients regain fertility after treatment, others experience permanent reproductive damage, and having preserved reproductive material provides future family-building options 1.
Key Considerations for Fertility Preservation
- For males, multiple semen samples collected 24-48 hours apart provide the best chance of successful preservation, with one to three samples collection being recommended 1.
- Females may require ovarian stimulation with hormonal medications like follicle-stimulating hormone for 10-14 days before egg retrieval, and the use of gonadotropins and letrozole or tamoxifen for ovarian stimulation is suggested for cancer patients 1.
- In cases where immediate treatment is necessary, females might consider ovarian tissue freezing, although this is still considered experimental 1.
- The risk of infertility varies based on the specific chemotherapy regimen, dose, patient age, and baseline fertility, with alkylating agents like cyclophosphamide posing particularly high risks to fertility 1.
Timing and Referral
- Time is of the essence, and fertility preservation treatments need to be completed before starting chemotherapy and/or irradiation 1.
- For men, sperm banking can be done quickly and can be done every 24 hours, as long as necessary, to collect the desired number of samples 1.
- For women, fertility preservation may take 2 to 4 weeks for established techniques, and timely referral to a reproductive specialist is important 1.
Protection of Ovarian Function
- The use of GnRH analogues concomitantly with chemotherapy should not be regarded as a reliable means of preserving fertility, as evidence for this is mixed and most studies reported on menstrual rather than on ovarian function, with no increase in pregnancy rates 1.
From the Research
Reproductive Sample for Fertility in Leukemia Patient with Chemotherapy
- There are no direct research papers to assist in answering this question regarding reproductive samples for fertility in leukemia patients with chemotherapy.
- However, studies have shown the effects of chemotherapy on leukemia patients, such as the treatment of acute leukemia in adults 2 and the use of dose-intensive chemotherapy regimens 3.
- Chemotherapy regimens, including doxorubicin and cyclophosphamide, have been used to treat various types of cancer, including breast cancer 4 and acute lymphocytic leukemia 3.
- The use of high-dose chemotherapy has been explored in the treatment of advanced breast cancer, with significant initial therapeutic effects but limited long-term benefits 5.
- The impact of chemotherapy on fertility is a concern for patients with cancer, and further research is needed to address this issue 6, 2.