title: Effect of low-dose testicular irradiation on sperm count and fertility in patients with testicular seminoma.
abstract: The treatment of seminoma with radiation therapy risks transient infertility. We have prospectively followed eight patients with stage I seminoma of the testicle. All patients underwent radical orchiectomy of the affected testis. The mean age of the patients was 32.9 years (range 24-40). Each patient was treated with megavoltage radiation with a 10- or 18-MV linear accelerator. The remaining testicle was shielded using a standard lead enclosure, and the mean testicular dose was 44 cGy (range 20.8-78.2). Semen specimens were delivered to the lab within 30 minutes of ejaculation. All specimens were analyzed using a computer-assisted sperm analyzer. Pretreatment parameters were within normal limits for all but one patient; one patient presented with a borderline normal sperm count at 18 and 22 x 10(6)/ml. Following treatment, there was a decrease in sperm count, detected at 3 months, to < 10 x 10(6)/ml (range 4.4- 8.6 x 10(6)) in all patients except one, who presented with an initial pretreatment count of 189 x 10(6)/ml, which decreased to 58 x 10(6)/ml at 3 months, 32 x 10(6)/ml at 6 months, and rose to 325 x 10(6)/ml by 12 months following treatment. Although the sperm count for this patient (D.L.) was within the normal range, the post-radiation sperm count was less than 20% of the pretreatment count. There was no difference in the motility at 3 months, the mean of which was 51.3%. One patient's (F.C.) wife conceived at 9 months following treatment, one at 12 months (J.R.), and one (J.S.) at 14 months, and all have delivered normal infants.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Obstetrics and Gynecology, University of Rochester Medical Center, New York 14642.
authors.forename: G M
authors.initials: GM
authors.lastname: Centola
authors.forename: J W
authors.initials: JW
authors.lastname: Keller
authors.forename: M
authors.initials: M
authors.lastname: Henzler
authors.forename: P
authors.initials: P
authors.lastname: Rubin
mesh_terms: D000328:Adult; D000368:Aged; D004307:Dose-Response Relationship, Radiation; D005298:Fertility / Q000528:radiation effects*; D006689:Hodgkin Disease / Q000150:complications / Q000473:pathology / Q000532:radiotherapy; D006801:Humans; D007248:Infertility, Male / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009919:Orchiectomy; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018239:Seminoma / Q000150:complications / Q000473:pathology / Q000532:radiotherapy*; D013076:Sperm Count / Q000528:radiation effects*; D013081:Sperm Motility / Q000502:physiology / Q000528:radiation effects; D013094:Spermatozoa / Q000473:pathology / Q000528:radiation effects; D013736:Testicular Neoplasms / Q000150:complications / Q000473:pathology / Q000532:radiotherapy*; D013737:Testis / Q000473:pathology / Q000502:physiology / Q000528:radiation effects*