How can chemotherapy affect a man's fertility?

Chemotherapy can affect male fertility in several ways:

• The alkylating chemotherapy group does the most damage to fertility. These drugs include cyclophosphamide (Cytoxan), chlorambucil (Leukeran), busulfan (Myleran), procarbazine (Natulan, Matulane), nitrosoureas (Carmustine, Lomustine), nitrogen mustard (Mustargen), and L-phenylalanine mustard (Alkeran).

• In high doses, agents that are used to treat cancers (including testicular cancer) can also damage fertility such as cisplatinum chemotherapy (Platinol) or bleomycin (Blenoxane, Bleomycin).

• A male is at higher risk for infertility as the dose level goes up. If a male gets two or more alkylating medicines and receives higher doses of chemotherapy, the risk is increased because the overall dose is likely to be higher. The total dose amount is the key.

Radiation is an independent factor for infertility. Combination therapies using chemotherapy plus pelvic radiation, full body radiation, and/or radiation to the brain increase the risk of infertility.