Birth Defects While on Chemotherapy
Dear OncoLink "Ask The Experts,"
concern is about the likelihood of my getting pregnant while he's on chemo. We are certainly not planning on it, and I have been on the [oral contraceptive] pill for 10 years, but what are the chances we would have an accident? And what kind of birth defects are expected? The drug guides don't really get that specific. Thank you!
Vicki Sherry, MSN, CRNP, Advanced Practice Oncology Nurse, responds:
The risk is theoretical, that is, there is no real data on chemotherapy's effect on male sperm or female eggs. Any chemotherapy can lead to birth defects. It is strongly recommended NOT to have children while your husband is taking chemotherapy. Chemotherapy works by damaging DNA and cell development. Using two forms of birth control, such as the pill and a barrier method (condoms), may increase the success rate of preventing an "accident".
There has been research on chemo's effects on fetuses. Here is a quote from a recent article:
The majority of the information on the effects of in utero exposure to chemotherapy has been derived from retrospective case reports and series. Overviews of the available data have concluded that the timing of chemotherapy exposure (first trimester versus second and third trimesters) as well as the chemotherapeutic agent or agents used affect the risk of spontaneous abortion and miscarriage as well as that of congenital abnormalities. Although there are data from a prospective series of 24 pregnant breast cancer patients treated at the University of Texas M.D. Anderson Cancer Center, there are limited case series in women with hematologic malignancies, with the largest series having 89 pregnancies, that indicate that the fetuses exposed to chemotherapy in utero in the second and third trimesters can be carried to term, be born without evidence of congenital abnormalities, and develop normally. Clearly, ongoing prospective collection of data on the children born to women undergoing therapy for cancer is necessary.
Children exposed to chemotherapy in utero. Journal of the National Cancer Institute. Monographs. (34):69-71, 2005.