Immune checkpoint inhibitors as a threat to reproductive function: A systematic review
Halahati Tuerxun, Yixin Zhao, Yixin Zhao, Yawen Li, Xingyu Liu, Shu‐Hui Wen, Jingjing Cao, Jiuwei Cui, Yuguang Zhao, Yuguang Zhao
Abstract
In recent years, the indications for immunotherapy in cancer treatment have been expanding. The increased risk of cancer in young people, coupled with the fact that many women or men choose to delay childbearing, has made an increasing number of patients of childbearing age eligible for immunotherapy. Furthermore, with the improvements of various treatments, more young people and children are able to survive cancer. As a result, long-term sequelae of cancer treatments, such as reproductive dysfunction, are increasingly important for survivors. While many anti-cancer drugs are known to cause reproduction dysfunction, the effects of immune checkpoint inhibitors (ICIs) on reproduction function remain largely unknown. Through a retrospective analysis of previous reports and literature, this article aims to elucidate the causes of reproductive dysfunction induced by ICIs and focus on their specific mechanisms, in order to providing some guidance to clinicians and patients. • The assessment of reproductive function in men and women of reproductive age treated with ICIs can no longer be postponed. • Clinicians need to balance the risk of ICIs-related hypogonadism or infertility with the reduced risk of disease recurrence before using ICIs and discuss it with the patient in advance. • Reproductive dysfunction caused by ICIs can be divided into two categories, one is primary reproductive dysfunction caused by direct effects on the gonads; the other is secondary reproductive dysfunction caused by hypophysitis. • In the future, we need further research in several areas to improve our understanding and management of ICIs-related reproductive dysfunction.