Pregnancy & Lactation : הריון/הנקה

4.6   Fertility, pregnancy and lactation

Fertility
In women, doxorubicin may cause infertility during the period of drug administration.
Doxorubicin may cause amenorrhoea. Ovulation and menstruation appear to return after termination of therapy, although premature menopause can occur.

Men being treated with doxorubicin are advised not to father a child during and up to 6 months after treatment and to seek advice on cryo-conservation (or cryo-preservation) of sperm prior to treatment because of the possibility of irreversible infertility due to therapy with doxorubicin.
Doxorubicin is mutagenic and can induce chromosomal damage in human spermatozoa. Oligospermia or azoospermia may be permanent; however, sperm counts have been reported to return to normospermic levels in some instances. This may occur several years after the end of therapy. Men undergoing doxorubicin treatment should use effective contraceptive methods.

Pregnancy
Doxorubicin should not be given during pregnancy. In general, cytostatics should only be administered during pregnancy on strict indication, and the benefit to the mother weighed against possible hazards to the foetus. In animal studies, doxorubicin has shown embryo-, feto- and teratogenic effects (see section 5.3).
Men and women should use effective contraception during and up to 6 months after treatment.
Women should not become pregnant during and up to 6 months after treatment.

Lactation
Doxorubicin has been reported to be excreted in human breast milk. A risk to the suckling child cannot be excluded. Since the use of doxorubicin during breast-feeding is contraindicated, breast-feeding should be discontinued during treatment with doxorubicin (see section 4.3).