Chemotherapy Drug Etoposide Used During Pregnancy Affects Future Fertility Of Female Offspring

Pregnant women with cancer, who use etoposide, may give birth to female babies who are likely to undergo an early menopause.

Highlights

A woman’s reproductive lifespan is determined before birth while ovaries are developing in the womb
The germ cells form structures called follicles during the 2^nd & 3^rd trimester, which determine how many eggs a woman will release in the future
In mouse ovary tissue grown in lab, chemotherapy drug called etoposide, which is considered safer during later stages of pregnancy, was found to damage the development of germ cells
Doctors should carefully weigh treatment options before applying it to prevent long-term side-effects

A study has revealed that the future fertility of unborn baby girls’ can be affected by chemotherapy treatment during pregnancy. In experiments conducted on mouse ovary tissue grown in the lab, researchers at the University of Edinburgh studied the effects of a drug called etoposide. The drug has been found to affect specialized cells called germ cells, that give rise to eggs.

Further research is paramount to assess the similar effects of the drug on human tissue. These findings call for intimation of a future possibility of early menopause in the affected baby girls.

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‘In pregnant women suffering from cancer, use of etoposide a cancer drug in the first trimester may affect the fertility of the female offspring.’

While cancer strikes one in 1000 pregnant women, doctors have to be prudent in their decision to use drugs that could help save both mother and babies without much side-effects. Etoposide use is considered to be in the second and third trimester of pregnancy because it lowers the risk of miscarriage and birth defects. It is used to treat several types of cancer.

A woman's reproductive lifespan is determined before birth, while the ovaries are developing in the womb. The female germ cells develop into structures called follicles during the second and third trimesters. This determines how many eggs a woman will be able to release in her lifetime. Follicles begin to develop at 17 weeks into baby’s development and continue until later stages of pregnancy. So this period is crucial in considering treatment options. However the longer term effects of the drugs on unborn baby still remains unclear.

The study published in the journal BMC Cancer stated that, if the drug when used on mouse ovary tissue grown in lab before the development of follicles, destroyed 90% of the germ cells even at lower doses. On the other hand after the development of follicles, no significant adverse effects were noted.

Etoposide

This medication is an anti-cancer agent, prescribed for lung cancer and testicular cancer.

Lead researcher Professor Norah Spears, of the University's Centre for Integrative Physiology stated "If the results we have seen in these mouse studies are replicated in human tissue, it could mean that girls born to mums who are taking etoposide during pregnancy have a reduced fertility window."

The study was funded by the Medical Research Council and the Biotechnology and Biological Sciences Research Council.

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References:

Cancer drug for mums-to-be may curb baby girls' future fertility - (http://www.eurekalert.org/pub_releases/2016-08/uoe-cdf080916.php)

Source-Medindia

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