Pregnancy While on Chemotherapy
Dear OncoLink "Ask The Experts,"
My sister is two months pregnant, and conceived about one month after her husband had chemotherapy for testicular cancer. He had the affected testicle removed and has only had one chemotherapy treatment with Carboplatin. She is now concerned about the normal development of the fetus. Some doctors have advised her to have an abortion based on the assumption that her husband’s chemotherapy has damaged the sperm DNA. In your experience, what is your advice?
Clarisa Gracia, MD, MSCE, Assistant Professor Obstetrics and Gynecology Division of Reproductive Endocrinology and Infertility at the University of Pennsylvania, responds:
It is generally recommended that patients who are being treated with chemotherapy or radiation therapy wait six months before conceiving due to the general risk of birth defects. At this time is no good evidence in humans to suggest a significant risk of chromosomal abnormalities in children born to men who were treated with carboplatin. However, animal studies have shown some sperm DNA damage.
In the situation where one gets pregnant within the period of risk, it becomes both a complicated and very personal matter. The decisions will be guided by your medical, personal, and spiritual guidance. If one is not willing to take the increased risk of genetic abnormalities then they might consider talking to their doctor about termination. Otherwise, an individual might continue the pregnancy with close monitoring with ultrasound and Chorionic villus sampling (CVS) or amniocentesis to detect gross chromosomal abnormalities. Keep in mind, many fetuses with major chromosomal abnormalities will miscarry.