Answer to Question #2443 Submitted to "Ask the Experts"

Q

My girlfriend is starting a cardiology fellowship and she will be required to perform cardiac catherizations. Will the exposure affect her ability to have kids?

A

The simple answer is no, but I will explain. Actually, in your girlfriend's circumstances the risks are very small. There are strict guidelines for performing cardiac catheterizations. They cannot exceed very low limits each month and year. They wear film badges and most importantly lead aprons so the ovaries receive much lower exposures. Her ovaries will receive extremely low exposures. Her risks for having a child with a genetic disease due to her irradiation are far below the risk of inheriting a genetic disease already present in her genes or resulting from a spontaneous mutation that occurs in a low frequency in all of us. I understand your concern and I will try to explain why your anxiety and concern is not warranted in your present situation. When you perform cardiac catherterization, the exposure of the radiation is not to her ovaries. The "scatter" that might reach the ovaries would be small and would not represent an increased risk for birth defects or miscarriage to her future embryo. The most important characteristic of x rays that concerns us is the dose. You may not know that we ourselves are radioactive and we are exposed to many sources of natural radiation that we cannot avoid. The data from the atomic bomb survivors who received much higher exposures indicates that genetic risks from radiation directly to the ovaries are very small. Studies of cancer survivors from studies performed by the National Cancer Institute also indicate that reproductive risks are barely increased even in women who were treated with chemotherapy and radiation to the ovaries. And remember, she will not have radiation to her ovaries. If she is healthy, and has no reproductive problems or family history of reproductive problems her risk for birth defects is 3% and for miscarriage, 15%. Neither you nor I can change that risk which all mothers have when they begin a pregnancy. Good luck with your family.

Robert L. Brent MD, PhD, DSc