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Research Article

Mutagenic Chemotherapy Exposure Precluding Gamete Preservation in Cancer Patients

Nicole L Longo

Correspondence Address :

Nicole L Longo, DO, FACOI
Departments of Quality of Life and Oncofertility Preservation
Cancer Treatment Centers of America
, Eastern Regional Medical Center
Philadelphia, 6211 Joshua Road, Fort Washington, PA 19034
USA
Email: nicolelee1123@gmail.com

Received on: March 10, 2016, Accepted on: March 22, 2016, Published on: March 28, 2016

Citation: Nicole L Longo (2016). Mutagenic Chemotherapy Exposure Precluding Gamete Preservation in Cancer Patients

Copyright: 2016 Nicole L Longo. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

  • Abstract

Abstract
Concerns for cancer therapy-related infertility rest largely upon the effect on hormonal and gonadal function, resulting in decreased gonadal reserve or premature failure. Recommendations for germ cell preservation are focused on these concerns but do not account for prior chemotherapy exposure that may potentially result in genetic mutations, possibly leading to birth defects. This investigational analysis is offered as a means to discern those agents and exposures which should be identified and preclude gamete preservation. An original analysis examining the documented pharmacokinetics and mutagenic toxicities of conventional chemotherapy was conducted. These results were then compared to administration rates of such agents at our institution. A substantial 54% of investigated agents (and metabolites) were found to be of mutagenic capability. The distribution pattern revealed mutagenic exposures within greater than one-third of the treated child-bearing population, an age bracket representing 27% of the total patient population. With greater than half of conventional chemotherapies having the capability to alter the DNA of oocytes and sperm, determination of prior exposures to mutagenic chemotherapeutics should be undertaken. If exposed, preclusion of gamete preservation in such circumstances may be warranted secondary to possible increased risk of genetic mutation potentially leading to birth defects, both physical and mental. Identifying such exposures in reproductive age patients fundamentally changes the current approach to fertility preservation.

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