Side effects of radiotherapy on fertility
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The side effects of radiotherapy on fertility are a growing concern to patients undergoing radiotherapy as cancer treatments. Radiotherapy is essential for certain cancer treatments and often is the first point of call for patients.[1] Radiation can be divided into two categories: ionising radiation (IR) and non-ionising radiation (NIR). IR is more dangerous than NIR and a source of this radiation is X-rays used in medical procedures, for example in radiotherapy.[2]
IR can have varying impacts which depend on many factors including age, irradiation field and treatment dose and duration. Where the radiotherapy is directed is important as IR to the pelvis will affect the ovary and uterus or testis. Whereas cranial irradiation will disrupt the hypothalamic-pituitary-gonadal axis (HPG-A), causing subsequent disruption of hormone secretion.[1]
In females, IR can have long-term effects on fertility, specifically on ovarian insufficiency, pubertal arrest and subsequent infertility.[1]
In males, the use of radiotherapy can disrupt the endocrine system leading to altered spermatogenesis and consequently a decrease in sperm count, sperm motility, sperm morphology and sperm viability.[2]
The rapid evolution of radiotherapy technologies has had the benefit of more effective and accurate treatments with less side effects.[3]