Is there a concern for the potential of future congenital malformations in offspring when preservation of eggs and sperm is done AFTER cyclophosphamide treatment given that it is an alkylating agent?

No, there is not a significant risk of congenital malformations in embryos created with cryopreserved gametes or unassisted pregnancies AFTER cyclophosphamide use.

While alkylating agents lead to both male and female infertility, congenital malformations from cyclophosphamide occur when conception happens while ON the medication not after. This is because cyclophosphamide forms permanent DNA cross-linkages which eventually cause cell death. However, cells have to be metabolically active and dividing for this to occur. Cryopreserved This is one of the reasons, however, that it's recommended to wait at least 3 months after a cyclophosphamide course to attempt conception for both males and females as well as for male cryopreservation.

Cyclopho...