How does gene therapy affect fertility?
Chemotherapy is an essential step in gene therapy. Chemotherapy depletes the stem cells in the bone marrow to make room for the modified blood stem cells. Chemotherapy can harm the reproductive system by damaging or destroying reproductive cells (eggs or sperm). This could prevent the ability to have children in the future.1
Women are born with all the eggs they will ever have.2 Eggs destroyed by chemotherapy cannot be restored.3 While men make sperm throughout their lifetime,4 chemotherapy can destroy sperm in the body and the cells that create sperm.5 If sperm in the body are destroyed, this may cause temporary infertility. But if the cells that create sperm are destroyed, fathering a child may not be possible.6 Patients who may want to have children in the future, should talk with their doctor about options for fertility preservation before starting gene therapy.7
What is fertility preservation?
Fertility preservation is a way to collect, freeze and store eggs or sperm for potential future use before starting gene therapy treatment.8
What are the options for fertility preservation?
Questions for your doctor
The decision to be a parent is very personal. Young people may not have thought about this yet. Because gene therapy may cause infertility, patients should talk to their doctor and people close to them. Here are some questions to ask the doctor or healthcare team:
References:
1 Fertility Issues in Girls and Women with Cancer. NCI. 2024. https://www.cancer.gov/about-cancer/treatment/side-effects/fertility-women
2 Infertility and Fertility. National Institute of Child Health and Human Development. https://www.nichd.nih.gov/health/topics/factsheets/infertility
3 Fertility Preservation Before Cancer Treatment: Options for People Born with Ovaries and a Uterus. Memorial Sloan Kettering Cancer Center.
https://www.mskcc.org/cancer-care/patient-education/fertility-preservation-females-starting-treatment
4 Sohni A, Tan K, Song H, et al. The Neonatal and Adult Human Testis Defined at the Single-Cell Level. Cell Reports. 2019;26, 1501. Doi: https://doi.org/10.1016/j.celrep.2019.01.045
5 Oktay K, Harvey BE, Partridge AH, et al. Fertility preservation in patients with cancer: ASCO clinical practice guideline update. J Clin Oncol. 2018;36(19):1994. doi:10.1200/JCO.2018.78.1914
6 Fertility Issues in Boys and Men with Cancer. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/side-effects/fertility-men#cancer-treatments-may-affect-a-males-fertility
7 Loren A, Senapatti S. Fertility preservation in patients with hematologic malignancies and recipients of hematopoietic cell transplants. Blood 2019; 134 (9): 754. Doi: https://doi.org/10.1182/blood.2018846790
8 What is Fertility Preservation? National Institute of Child Health and Human Development. https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/fertilitypreservation
9 Han E, Seifer D. Oocyte Cryopreservation for Medical and Planned Indications: A Practical Guide and Overview J. Clin. Med. 2023, 12(10), 3542; https://doi.org/10.3390/jcm12103542
10 Loren A, Senapatti S. Fertility preservation in patients with hematologic malignancies and recipients of hematopoietic cell transplants. Blood 2019; 134 (9): 749. Doi: https://doi.org/10.1182/blood.2018846790 11 Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion. 2019. Practice Committee of the American Society for Reproductive Medicine.
https://www.asrm.org/practice-guidance/practice-committee-documents/fertility-preservation-in-patients-undergoing-gonadotoxic-therapy-or-gonadectomy-a-committee-opinion-2019/
The information in this resource is for educational purposes only, not intended to be comprehensive, and is not intended to provide medical advice. Patients should always talk to their doctor with questions about their medical care. Links to websites are for informational purposes only.
