Effect of chemo- or radiotherapy on sperm parameters of testicular cancer patients.
BACKGROUND
The aims of our study were to investigate the short- and long-term effects of chemo- or radiotherapy on spermatogenesis in patients with testicular cancer and to establish any correlation between pre-therapy sperm parameters, histotype and treatment type/intensity and the progress of spermatogenesis during the post-therapy period.


METHODS
We evaluated 166 patients affected by testicular cancer, who cryobanked about 1 month after the removal of the cancerous testis and before beginning chemo- (CH group; n = 71) or radiotherapy (RT group; n = 95).


RESULTS
For the CH group, there was a statistically significant decrease in sperm parameters, which was most significant 3 months after the end of chemotherapy. For the RT group, this decrease was most relevant 6 months after the end of radiotherapy. Two years after therapy, 3% of the CH group and 6% of the RT group remained azoospermic. To evaluate whether spermatogenesis recovery is a function of baseline semen quality, we divided each group into two subgroups by pre-therapy total sperm count (A, <40 x 10(6)/ejaculate; B, >or=40 x 10(6)/ejaculate). At t(24), subgroup A of both the CH and RT groups showed improved sperm parameters over the baseline, whereas subgroup B for both CH and RT groups showed a return of sperm parameters to those of baseline values.


CONCLUSIONS
In conclusion, the recovery of spermatogenesis after chemo- or radiotherapy in our group of testicular cancer patients was not a function of pre-therapy sperm parameter quality. Cryopreservation of sperm before performing such therapy is therefore imperative.
Gandini
Loredana
L
Laboratory of Seminology and Immunology of Human Reproduction, Department of Medical Pathophysiology, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy. loredana.gandini@uniroma1.it
Sgrò
Paolo
P
Lombardo
Francesco
F
Paoli
Donatella
D
Culasso
Franco
F
Toselli
Lucia
L
Tsamatropoulos
Petros
P
Lenzi
Andrea
A
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D053713:Azoospermia / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D011877:Radionuclide Imaging; D012661:Semen / Q000187:drug effects / Q000528:radiation effects; D013094:Spermatozoa / Q000187:drug effects* / Q000528:radiation effects*; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D013997:Time Factors
D000970:Antineoplastic Agents