Immunotherapy and Fertility

Posted By
newmanmark
11/15/2017 10:36am
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Replies: 5

I have been on Opdivo/Yveroy for the past year with very good results.  We are now taking a break and will likely wait and watch what happens.  My wife and I have put off having a third child due to my health and the treatments I have been on.  I was wondering if anyone has had the discussion with their oncologist or knows of any literature on the subject?  I am male so my concern is whether the treatment has any affect on my sperm and is it not advised to have children while this immunotherapy is still working inside me?  Or is there a period of time that I should wait before conceiving?

Thanks!

Mark

MovingOn - (11/15/2017 - 10:55am)

I can’t be of direct/experienced help but I can recommend that you see a fertility specialist doctor. After we had 4 miscarriages we went to a fertility specialist at our health system. I thought they would only be testing my wife’s overall health (blood tests, etc), but they started off by testing my sperm. So I would think it would be good to have a sperm test after immunotherapy just as a precaution. I’m beyond the timeframe of having more kids (two successful children after the miscarriages) but if I were having more children then, due to my hypophysitis from Ipi, I would certainly be getting myself checked for fertility.

2018 is a new year!

newmanmark - (11/15/2017 - 12:30pm)

I also had hypophysitis and will now likely be on hydrocortisone for the rest of my life.  What’s the outcome of your hypophysitis?

 

MovingOn - (11/15/2017 - 5:51pm)

My hypophysitis occurred at the end of April. Since then I’ve been on 88mcg of levothyroxine, 10-20 mg of hydrocortisone (based on need but i usually take 15-20mg), and have androderm patch for testosterone.

Interestingly my thyroid stimulating hormone has been rising at each 3-6week interval of blood tests for Keytruda. TSH 0.023 On May 8th. TSH 0.088 On 10/25. Needs to get to .358 for the low end of the normal range. Regarding cortisol, I get a headache a few hours after if I miss a dose. The headache gets progressively worse until I get the hydrocortisone (then takes about 30-45 minutes until the headache resolves).

Hopefully your endocrine aspects of hypophysitis have improved or completely resolved.

2018 is a new year!

MovingOn - (11/20/2017 - 12:27am)

Just wanted to add an update: I received the results of another TSH test and it is 0.037 so I guess my increase in TSH was short lived and now I’m back down near the bottom.

2018 is a new year!

My oncologist, Dr. Katy Tsai just started a study at UCSF testing male fertility while on immunotherapy treatment. It has never been looked into before, so there is no literature yet and no way to know. The original idea was that it would not have any effect but since time has gone on we have learned how these drugs can negatively impact our hormone glands. This is why she wanted to start this study. It will probably be a while before we have any info from this study. 

I would not conceive while on treatment, just to be on the safe side, not sure what recommendations there are for men, but I know women are advised not to get pregnant for at least 3-6 months after finishing immunotherapy. So, I would wait, just to be on the safe side.

Jenn - stage IV - Ipi/Nivo (Yervoy/Opdivo); Completed a year of infusions and surgery to remove last tumor