Hi, Thanks for writing in. Etoposide can cause reduced ovarian reserve in females and infertility in males. Males appear more susceptible than females to ifosfamide gonadotoxicity. There may be a dose in males below which the risk of subfertility is low. In females there is preliminary evidence of reduction in ovarian reserve, which may potentially lead to an early menopause and a reduction in the window of fertility. Vincristine is typically less likely to harm fertility. Some of these drugs also may interrupt menstruation in girls and/or cause early menopause. In females of reproductive potential, Doxorubicin may cause infertility and result in amenorrhea. Premature menopause can occur. Recovery of menses and ovulation is related to age at treatment. Doxorubicin may result in oligospermia, azoospermia, and permanent loss of fertility. Sperm counts have been reported to return to normal levels in some men. This may occur several years after the end of therapy