Immune Checkpoint Inhibitors Impact Fertility: A Review.

Abstract

Immune checkpoint inhibitor therapy has become the established method of treatment for various types of cancers, consequently introducing a spectrum of side effects referred to as immune- mediated adverse events, affecting almost every organ, including the reproductive system. Moreover, very little clinical data is available that suggests the detrimental effect of immune checkpoint inhibitor therapy on fertility, sexual health, or potential pregnancies. In this manuscript, we reviewed the impact of immunotherapy on male and female fertility and its effect on sexual health. Patients undergoing systemic treatment with immunotherapy often experience sexual dysfunction, decreased sexual drive, erectile dysfunction, and a decline in vaginal lubrication. Fertility-desiring patients who do not receive adequate counseling may ultimately face a higher likelihood of developing anxiety, depression, and a decreased quality of life post-treatment. Therefore, it is crucial to address the reproductive consequences of planned treatment, disseminate knowledge about novel treatments and preventive measures for reproductive side effects, and provide guidance on fertility preservation. Individuals experiencing secondary reproductive dysfunction due to the tumor or its treatment should receive proactive treatment for the underlying condition and be offered hormone replacement therapy.