Question
Which chemotherapy drugs used for breast cancer treatment may cause me to become infertile?Answer
The drugs used for breast cancer treatment are only one factor that can cause infertility. Your age during treatment, higher drug doses, a greater number of doses, and combinations of drugs may all contribute to chemo-induced ovarian failure (CIOF), or infertility.If you are nearing menopause, chemo may push you into it a bit early. This is especially true if you are over 45 years old, and part of your chemo includes a taxane drug (paclitaxel or docetaxel). Family medical history, smoking, and body mass index are also factors in early menopause.
If you are not already in menopause before you start chemo, consider your options before you begin treatment. Discuss your thoughts about fertility with your doctor to get help weighing the benefits of treatment with the possibility of your loss of fertility.
Here is a list of drugs that have been studied and found to cause infertility:
- A - doxorubicin (Adriamycin)
- C - cyclophosphamide (Cytoxan, Neosar)
- E - epirubicin (Ellence, Pharmorubicin)
- F - 5-fluorouracil (5Fu)
- M - methotrexate (Trexall, Rheumatrex))
- P - paclitaxel (Taxol)
- T - docetaxel (Taxotere)
Chemo and Infertility Factors
| Drug Combinations | Doses | Patient Age | Chance of Infertility Due to Chemotherapy |
| CMF | 6 | <40 | 30–80 percent |
| ≥40 | 60–96 percent | ||
| AC | 4 | <40 | 13–30 percent |
| ≥40 | 57–63 percent | ||
| FEC/FAC | 6–8 | <40 | 10–25 percent |
| ≥40 | 80–90 percent | ||
| AC followed by P | 4 (each drug) | <40 | 35 percent |
| ≥40 | 77 percent | ||
| AC followed by T | 4 (each drug) | <40 | 29–42 percent |
| ≥40 | 66–75 percent | ||
| TAC | 6 | any age | 61.7 percent |
| Source: Breast cancer treatment and ovarian failure: risk factors and emerging genetic determinants, Vered Stearns, Bryan Schneider, N. Lynn Henry, Daniel F. Hayes and David A. Flockhart, Nature, Perspectives, Vol. 6, November 2006, pages 886 - 893, PDF document from www.nature.com/reviews/cancer | |||
