Semen analysis and cryoconservation before treatment in Hodgkin's disease.
BACKGROUND
The prophylaxis of the late effects of chemotherapy and radiotherapy has become one of the major concerns in the management of Hodgkin's disease (HD). Unlike other complications, male sterility could be managed by prior semen preservation (SP).


METHODS
To evaluate the semen quality of patients with HD and the outcome of insemination, we reviewed spermograms of patients who underwent SP before any treatment. The following criteria were necessary: 1) age > 16 and < 50; 2) HD of any stage; 3) informed about male sterility after HD treatment; 4) fully consenting.


RESULTS
Such a proposal was made to 316 men, and 94 fulfilled the criteria. All patients underwent an initial chemotherapy. Mean age of the cohort was 27.5 years (range 16-48 years). Pretherapeutic staging of HD revealed 38 stage I (40%), 38 II (38%), 14 III (15%) and 4 IV (4%). Semen analysis before cryoconservation showed an overall 53% of normal or subnormal cases (50 cases). The analysis of semen quality and spermatozoid amount according to various parameters failed to find a correlation with stage, B symptoms, age, or biologic data (LDH, WBC, platelets, ESR). The use of cryopreserved semen was requested by 13 patients; 88 inseminations were performed leading to 9 pregnancies and 2 births.


CONCLUSIONS
The low rate of success with cryopreserved semen in these cases suggests the need for a more careful design of non-toxic chemotherapy regimens in combined modality treatment.
Fitoussi
Bone Marrow Transplant Unit/Hospital Haut-Leveque, Pessac, France.
Eghbali
H
H
Tchen
N
N
Berjon
J P
JP
Soubeyran
P
P
Hoerni
B
B
D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy / Q000009:adverse effects; D015925:Cryopreservation; D006689:Hodgkin Disease / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D007248:Infertility, Male / Q000209:etiology; D007258:Informed Consent; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D012661:Semen / Q000737:chemistry / Q000166:cytology*; D012662:Semen Preservation; D013997:Time Factors