Breast cancer in young women: effect of chemotherapy on ovarian function, fertility, and birth defects.

A comprehensive review of the literature was done to assess the effect of adjuvant chemotherapy for operable breast cancer on ovarian function, fertility, and birth defects. Data were limited. Cyclophosphamide, an alkylating agent, is the major cause of amenorrhea, which is due to primary ovarian failure. Ovarian dysfunction is related to age, dose, and duration of treatment. In women less than 35, pregnancy following adjuvant chemotherapy is possible. However, data are limited regarding the impact of subsequent pregnancy on the results of breast cancer. There appears to be no increased risk of teratogenesis in offspring exposed to chemotherapy after the first trimester of pregnancy. Prospective data on women who have subsequent pregnancies and on their offspring are very limited. Formation of a registry for long-term follow-up of young women detailing reproductive potential and follow-up of offspring is needed.