Radiation and Fertility

Intervention #11 Exposure to Radiation
 
Fact Check

  • Reduce exposure to non-ionized radiation (mobile phones, computers, wi-fi, microwave).
  • Consider antioxidants to minimise impact of non-ionized radiation.
  • Avoid exposure to ionized radiation (medical procedures) as far as possible.
  • Consider fertility preservation if ionized radiotherapy in high doses is required.
In modern society people are frequently exposed to different types of radiations, from different sources.

It could be either related to everyday life (e.g. televisions, mobile phones, computer devices, occupational equipment) or to the necessity of medical care (e.g. diagnostic imaging, interventional radiology procedures, anticancer therapy).

Types of Radiation

Non-ionizing: these are electromagnetic fields (EMFs) that do not have enough energy to release electrons (non–ionizing), but are able to excite the movement of an electron to a higher energy state. These can be:
  • Extremely low frequency (ELF)/ Power line (60Hz) electromagnetic fields (EMFs)
  • Radio Frequency (RF) EMFs (produced by wireless radio waves): computer monitors, AM radio transmissions, hand phones, microwave ovens, laptops and Wi-Fi
Ionizing: These are high energy radiations that are capable to knock electrons off an electron shell leaving the atoms with a net positive charge (ionization). The biological consequence on human cells of this electron strip is direct or indirect damage of cell’s DNA. This is the radiation used in medical care (diagnostic imaging and procedures, radiotherapy).

Non ionizing RF EMFs

Includes frequencies used for cell phones, laptops, computers, microwave ovens and some other higher frequency range.

Induces oxidative stress with an increased level of reactive oxygen species.

Reduces progressive motile sperm count, motility and viability.

Increased risk of miscarriage.

Impact depends on duration of the exposure, distance to the source of radiation, power density, and depth of the penetration.

Ionizing Radiation

This is the radiation used in medical care (diagnostic imaging and procedures, radiotherapy).

Direct damage to cell’s DNA: the displaced electron breaks the DNA strand.

Indirect damage to cell’s DNA: the electron reacts with a water molecule resulting in the creation of free radicals that in the end also damage the cell’s DNA.

Ionizing Radiation – Ovarian Effects
During radiotherapy, besides the tumour itself, the radiation field may also include healthy tissues close to the tumour that are unavoidably exposed to radiations. Although in some tissues the damage is reversible, in the ovary it is progressive and permanent.

Follicular atrophy and reduced follicle stores, Impaired ovarian hormones production, uterine dysfunction due to inadequate oestrogen exposure, early menopause.

The extent of the damage that occurs in the ovary depends on several factors such as age of the patient (the younger is the patient at the time of radiation, the greater is the damage), exposure dose, exposure time and eventually associated chemotherapy.

Ionizing Radiation – Uterine Effects
Altered uterine vascularization, decreased uterine volume and elasticity.
Myometrial fibrosis and necrosis, endometrial atrophy and insufficiency.
Ulceration and necrosis can last several months, and the damaged tissue may be replaced by dense collagen deposition.
The cervix gets quite atrophic and loses its elasticity.

Ionizing Radiation – Sperm Effects
Lower doses, affect the germinal epithelium. Doses of irradiation greater than 0.35 Gy cause aspermia, which may be reversible.
The time taken for recovery increases with larger doses; however, with doses in excess of 2 Gyaspermia may be permanent.