Gonadal injury resulting from chemotherapy.

Radiation, alkylating agents and the vinca alkaloids produce variable degrees of gonadal dysfunction in humans; additional drugs have been linked to gonadal damage in males only. Age at time of exposure and total dose of drug administered are associated with the degree of gonadal injury. Irreversible sterility develops at lower doses in men than in women. The infertile men usually retain sexual function, whereas the infertile women experience premature menopause and sexual dysfunction. Subfertility with normal sexual function is the sequela of lesser degrees of gonadal injury in men and women. For a given drug dose, children apparently sustain less gonadal damage than their adult counterparts. Rigorous reporting of basic essential data will enhance our understanding of drug-induced gonadal damage; incomplete reports only cloud the issue.