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Preserving fertility: using cyclophosphamide and other cytotoxics in young people
  1. David Ledingham1,
  2. Michael Plant2,
  3. Fayez Mustafa3,
  4. Bhimanagouda Patil1
  1. 1 Neurology, James Cook University Hospital, Middlesbrough, UK
  2. 2 Rheumatology, James Cook University Hospital, Middlesbrough, UK
  3. 3 Reproductive Medicine, James Cook University Hospital, Middlesbrough, UK
  1. Correspondence to Dr David Ledingham, Neurology, James Cook University Hospital, Middlesbrough TS4 3BW, UK; dledingham3{at}


Cytotoxic agents such as cyclophosphamide are infrequently used in neurological practice. When they are, it is commonly in critically ill patients or in those with refractory inflammatory disorders. Cyclophosphamide in particular has a well-recognised negative impact on both female and male long-term fertility. This article summarises the data with regards the impact of cytotoxics on long-term fertility and describes the current options to preserve fertility in these patients. We hope this will provide neurologists with a useful aid for counselling patients for whom they are considering these treatments.

  • Cyclophosphamide
  • Fertility
  • Cytotoxic

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  • Contributors DL and BP came up with the concept for the article. DL wrote up the case and summarised the literature. BP reviewed the neurological aspects of the paper, MP the rheumatological/cyclophosphamide aspects and FM the fertility aspects.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Commissioned; externally peer reviewed by Mohar Goswami (London, UK) and Angela O’Neal (Boston, USA).

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