Checkpoint inhibitors, fertility, pregnancy, and sexual life: a systematic review

ESMO Open. 2021 Oct;6(5):100276. doi: 10.1016/j.esmoop.2021.100276. Epub 2021 Sep 28.


Immune checkpoint inhibitors (i.e. anti-PD1, anti-PDL1, and anti-CTLA4) have revolutionized the therapeutic approach of several cancer types. In a subset of metastatic patients, the duration of the response is so long that a cure might be hypothesized, and a treatment discontinuation strategy could be proposed. Considering that long-term efficacy, some patients could also plan to have a child. Moreover, immunotherapy is moving to the early setting in several diseases including melanoma and breast cancer that are common cancers in young patients. However, there is a paucity of data about their potential detrimental effect on fertility, pregnancy, or sexuality. Herein, we conducted a systematic review with the aim to comprehensively collect the available evidence about fertility, pregnancy, and sexual adverse effects of checkpoint inhibitors in order to help clinicians in daily practice and trialists to develop future studies.

Keywords: checkpoint inhibitors; fertility; immunotherapy; pregnancy; sexuality.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Child
  • Drug-Related Side Effects and Adverse Reactions*
  • Female
  • Fertility
  • Humans
  • Immunologic Factors
  • Immunotherapy / adverse effects
  • Melanoma*
  • Pregnancy


  • Immunologic Factors