Chemotherapy Drug in Pregnant Patients May Affect Future Fertility of Child

A chemotherapy drug, etoposide, damaged the development of ovarian tissue grown in the lab, indicating a potential effect on the future fertility of unborn baby girls, according to a recent study.

Researchers from the University of Edinburgh found that the drug affects specialized germ cells associated with egg production. During the study, researchers found that treatment before the follicles developed ended up wiping out up to 90% of the germ cells, even with relatively low doses administered to patients.

Follicle development starts around 17 weeks while the baby is in the womb, and is not completed until the later stages of pregnancy. Research has shown that treatment after the follicles were completely developed showed no significant adverse effects.

Approximately 1 in 1000 pregnant women are diagnosed with cancer, and both physicians and patients have to make decisions to try and save both the mother and baby. Etoposide is used to treat several types of cancer, and is often used because it is considered safe for pregnant women who are in their second or third trimester.

Although the drug has a low risk of miscarriage and birth defects, the long term effects it has on the unborn baby later in life is unclear. Authors noted the findings suggest that affected baby girls should be warned in later life that they may undergo early menopause, but more research needs to be done to assess if etoposide has similar effects on human tissue.

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