“Chemotherapy exposure during the first trimester is contraindicated and increases the risk of spontaneous abortion, fetal death, and major congenital malformations. Second- and third-trimester exposure may affect some body systems still developing and can still result in fetal growth restriction, low birth weight, and preterm labor. Yet, I do want to stress that pregnancy can remain a possibility,” Kelsey Miller, MSN, RN, AGCNS-BC, OCN®, clinical nurse specialist in oncology and infusion therapy at Reading Hospital in West Reading, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about policies and procedures for pregnancy testing during cancer treatment.
Music Credit: “Fireflies and Stardust” by Kevin MacLeod
Licensed under Creative Commons by Attribution 3.0
Earn 0.25 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by May 10, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center’s Commission on Accreditation.
Learning outcome: Learners will report an increase in knowledge related to pregnancy screening procedures during cancer treatment.
Episode Notes
To discuss the information in this episode with other oncology nurses, visit the ONS Communities.
To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.
To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.
Highlights From This Episode
“It’s really crucial to identify [pregnancy] prior to treatment, as this should be considered a patient safety ‘never’ event. We know that exposure to chemotherapy or radiation can cause mutagenic changes in reproductive cells and teratogenic effects in a developing fetus. Women of childbearing potential should have a documented pregnancy test prior to beginning cancer treatment due to the adverse effects of chemotherapy and radiation on a developing fetus.” TS 1:42
“We had a fertility risk checklist that was based off American Society of Clinical Oncology standards, that was not fully operationalized nor built into physician workflows. The checklist was a way of documenting that risks of infertility, fertility preservation, and contraception was discussed, as well as an attestation that referral to a reproductive endocrinologist was made if needed. I had a physician partner at the time who said the only way to get the providers to fill out this checklist is to make it a hard stop, so that’s what we did. The fertility risk checklist is now a hard stop by means of an order validation that will pop up when the provider goes to sign the oncology treatment plan, and it will say, ‘Orders cannot be signed unless the fertility risk checklist is complete.’” TS 9:27
“Whenever I develop teams, I like to share a common vision. We’re all here for patient safety, and we want to prevent harm by pregnancy screening these patients that could potentially become pregnant during cancer treatment.” TS 13:20
“There’s a misconception that all cancer therapy will render patients infertile, and this is not the case. Even though chemotherapy and radiation reduce fertility and may cause premature ovarian failure, many patients still remain fertile. And we know from research that physical intimacy remains important during cancer treatment, and unintended pregnancies may occur.” TS 18:13
Episode 313: Cancer Symptom Management Basics: Other Pulmonary Complications
Episode 312: Virtual Nursing in Health Care
Episode 310: Pharmacology 101: Androgen Receptor Inhibitors and Antiandrogens
Episode 309: What Brings You to ONS Congress®?
Episode 308: Hazardous Drugs and Hazardous Waste: Personal, Patient, and Environmental Safety
Episode 307: AYAs With Cancer: Financial Toxicity
Episode 306: Cancer Symptom Management Basics: CNS Toxicities
Episode 305: Pharmacology 101: Nitrosoureas
Episode 304: Nursing Roles in FDA: The Drug Labeling and Package Insert Process
Episode 303: Cancer Symptom Management Basics: Ocular Toxicities
Episode 302: Patient Navigation Eliminates Disparities in Cancer Care
Episode 301: Radiation Oncology: Side Effect and Care Coordination Best Practices
Episode 300: AYAs With Cancer: End-of-Life Care Planning
Episode 299: Pharmacology 101: Plant Alkaloids
Episode 298: Radiation Oncology: Nursing’s Essential Roles
Episode 297: Intra-Arterial Chemotherapy Administration: The Oncology Nurse’s Role
Episode 296: Pharmacology 101: Anthracyclines and Other Antitumor Antibiotics
Episode 295: Cancer Symptom Management Basics: Pulmonary Embolism, Pneumonitis, and Pleural Effusion
Episode 294: AYAs With Cancer: Clinical Trial Enrollment Barriers and Facilitators
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