Chemotherapy Could Affect Reproductive Lifespan of Unborn Female Fetuses

A recent study found that if the chemotherapy drug etoposide is administered to a pregnant patient, it can potentially alter the fertility of unborn female fetuses.

Etoposide blocks an essential enzyme and cause cancer cell DNA to become tangled, preventing cell division. The drug is used to treat various forms of cancer.

Chemotherapy during the first trimester is generally not recommended, but is considered safer to be administered during the second and third trimesters. Several previous studies have shown that women who receive chemotherapy during later trimesters do not deliver infants with apparent birth defects.

However, reproductive effects would not be seen until much later in the child’s life.

Researchers in the current study, which was published by BMC Cancer, discovered that etoposide damages the development of lab-grown ovary tissue in mice, and affects germ cells that initiate egg production. The second and third trimesters are critical for female reproductive lifespan determination, since this is when female germ cells create follicles, which determines how many eggs will be released.

Researchers discovered that 90% of germ cells were eliminated if chemotherapy was initiated prior to follicle development, according to the study.

“If the results we have seen in these mouse studies are replicated in human tissue, it could mean that girls born to moms who are taking etoposide during pregnancy have a reduced fertility window,” said researcher Norah Spears, PhD.

If the treatment started after follicle development, no adverse effects on reproductive health was seen. Researchers said that damage to germ cells could also be passed on to future generations.

Since pregnant women are currently treated with etoposide, the researchers caution that this drug may have similar effects on human fetal ovaries.