Assess and Compare the Infertility Rates Associated with Cyclophosphamide and Lostine in Cancer Patients

Background: Infertility is a major issue in cancer survivors, particularly after they are subjected to chemotherapy. Alkylating chemotherapeutic agents commonly used, such as cyclophosphamide, has been reported to have gonadotoxic effects. However, in comparison, the reproductive consequences of the newer chemotherapeutic agent of Lostine are still poorly defined.
Purpose: The purpose of the study was to compare and contrast the levels of infertility, changes in hormonal levels, and quality-of-life parameters between cancer patients who received Cyclophosphamide and those who received Lostine.
Methods: A comparative cohort study was conducted among 140 patients with cancers, where in 70 patients were in a group that was treated with Cyclophosphamide, and 70 patients were treated with Lostine. The information, including demographic characteristics, infertility, and latency to infertility, hormonal levels (FSH, LH, estradiol), quality-of-life measures, adverse outcomes, and patient satisfaction, were carefully recorded. Determinants of infertility were identified by use of logistic regression analyses.
Findings: Infertility was much higher in the Cyclophosphamide group (42.9 percent) as compared with the Lostine group (21.4 percent). The gonadal dysfunction was shown by the strong levels of FSH and LH in the presence of decreased estradiol in cyclophosphamide-treated patients. On the contrary, the Lostine group had relatively steady hormonal values, better patient satisfaction (80% vs. 65%), and quality-of-life ratings (70 vs. 60). The cases of adverse events were significantly higher in recipients of Cyclophosphamide. Cyclophosphamide exposure and hormone perturbations were found to be some of the strong predictors of infertility with the help of logistic regression analysis.
Conclusions: Cyclophosphamide has a significantly increased risk of infertility and hormonal imbalance compared to Lostine. Strategies to preserve fertility and extensive counselling need to be part of it, especially among younger patients. Future studies are justified to outline the long-term reproductive outcomes of Lostine.