Table 2. Risk factors for chemotherapy-induced infertility.
Factor Effect on Women Effect on Men Key Examples/Notes Reference
Type of Drug Alkylating agents (e.g., cyclophosphamide) can destroy oocytes, causing permanent infertility. Platinum drugs (e.g., cisplatin) also harm ovaries. Alkylating agents (e.g., cyclophosphamide) often lead to no sperm (azoospermia). Platinum drugs (e.g., cisplatin) damage sperm production. Cyclophosphamide, cisplatin are high-risk; taxanes are milder. Bhardwaj et al., 2023
Dosage Higher doses increase the chance of losing all oocytes, leading to early menopause. Bigger doses raise the risk of permanent sperm loss, especially with multiple drugs. More damage with higher cumulative doses. Poorvu et al., 2019
Age Older women (over 35) lose fertility faster due to fewer oocytes left, while younger women may recover better. Older men (over 40) recover sperm slower or not; younger men have a better chance. Age 35+ for women, 40+ for men heightens risk. Horan, 2022
Pre-existing Fertility Health Women with issues like endometriosis or PCOS lose oocytes more easily, risking infertility sooner. Men with low sperm count or poor motility before treatment face worse fertility loss. Conditions like PCOS or low sperm count worsen outcomes. Papathanasiou et al., 2024