| Table 1. Effects of chemotherapy drugs and bumetanide on fertility: a comprehensive overview of commonly used agents and their reproductive impacts. |
| Drug Name |
Effects on Fertility |
References |
| Cyclophosphamide |
It can cause infertility, particularly in women,
leading to premature ovarian failure. Risk increases with age and
dose. In men, it may cause azoospermia or oligospermia. Fertility
preservation (e.g., oocyte/sperm freezing) is recommended. |
Huong et al.,
2002; Gajjar et
al., 2015; Mansilla et al., 2019
|
| Doxorubicin |
It may cause ovarian toxicity in women, reducing
ovarian size and ovulation rates, potentially leading to
infertility. Limited data on male fertility, but some gonadal impact
is possible. |
Ben-Aharon et al.,
2010; Poorvu et
al., 2019; Mohan et al., 2021
|
| Paclitaxel |
Likely has transient effects on fertility, with
milder ovarian toxicity in women and potential recovery. In men, it
may cause temporary sperm DNA damage, but the effects are less
severe than other drugs. |
Tarumi et al.,
2009; Ili et
al., 2019;
Ma et al.,
2020
|
| Cisplatin |
It can cause significant infertility, especially in
men, with reduced sperm production and testicular damage. In women,
it affects ovarian reserve, leading to potential infertility. |
Schrader et al.,
2001; Abdel-Latif
et al., 2022; ASCO, 2025
|
| Methotrexate |
It may have temporary effects on fertility,
particularly in women, with reversible impacts on oocyte production.
In men, recent studies suggest minimal long-term fertility impact. |
French et al.,
2003; Zarén et
al., 2023
|
| Fluorouracil (5-FU) |
Generally has minimal direct impact on fertility,
with limited evidence of significant gonadal toxicity. Effects may
be secondary to overall treatment regimen rather than the drug
alone. |
Fuchs et al.,
2017; Razzaque,
2018; NCI, 2025
|
| Vincristine |
Typically has low gonadotoxicity, with minimal direct
effects on fertility in both men and women. Recovery of reproductive
function is common post-treatment. |
Bandino et al.,
2018; NIDDK, 2023
|
| Etoposide |
Can impair fertility, particularly in men, with
potential for azoospermia at high doses. In women, it may reduce
ovarian reserve, though effects are less severe than alkylating
agents. |
Cavalcanti et al.,
2006; Joyisa et al., 2019 |
| Bumetanide |
No direct evidence suggests it affects fertility in
men or women. As a diuretic, not a chemotherapy drug, it lacks
gonadotoxic properties typical of cancer treatments. |
NHS, 2022; Drugs.com,
2025
|
| Bortezomib |
Limited evidence suggests minimal direct impact on
fertility. Studies indicate it may not significantly affect ovarian
or testicular function, though data is sparse and often confounded
by combination therapies. |
Zhen et al.,
2018; NIDDK, 2020
|
| Carboplatin |
Can affect fertility, particularly in men, with
potential for reduced sperm count, though less severe than
Cisplatin. In women, it may cause ovarian damage, but the risk of
permanent infertility is lower than with Cisplatin. |
Razzaque, 2018; Joyisa et al.,
2019; NCI, 2024
|
| Ifosfamide |
Another alkylating agent with significant infertility
risks, similar to Cyclophosphamide. Can cause premature ovarian
insufficiency in women and azoospermia in men, with dose-dependent
effects. Fertility preservation is often advised. |
Huang et al.,
2005; Fuchs et
al., 2017
|
| Bleomycin |
Used in testicular cancer, with moderate fertility
effects, often reversible in men. In women, ovarian impact is less
studied but appears minimal compared to alkylating agents. |
ASCO, 2025
|
| Gemcitabine |
An antimetabolite with limited fertility data but
potentially milder effects. It may cause temporary ovarian or
testicular dysfunction, with evidence suggesting recovery in many
cases. |
Razzaque, 2018; Joyisa et al.,
2019; ASCO, 2025
|