Gonadal function and fertility in male survivors treated for Hodgkin's disease in Iran.
OBJECTIVE
To investigate the effect of chemotherapy on gonadal function of young men cured of childhood Hodgkin's disease.


METHODS
Young adult males surviving Hodgkin's disease, aged 17 and over at least 2 years after therapy were studied in Ali Asghar Children's Hospital, Tehran, Iran from March 2000 to March 2005. Clinical evaluation for secondary sexual characteristics, semen analysis, follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone was studied in 33 survivors of Hodgkin's disease.


RESULTS
The age at diagnosis was 5-15 years, median 9 years, age at study 17-29 years, median 19 years old. The median duration off therapy was 7 years (2-20 years). All 33 patients received chemotherapy as follows: 32 patients received nitrogen mustard (mechlorethamine), vincristine (Oncovin), procarbazine, prednisone (MOPP) / doxorubicin (adriamycin), bleomycin, vinblastine, dacarbazine (ABVD) 6-8 cycles, 5 of whom after relapses received other protocols. One received only MOPP. Twenty-seven (81.8%) had azoospermia, 2 had severe oligospermia, 3 had oligospermia, and one had normal sperm count (58000,000). All patients had normal secondary sexual characteristic. The FSH, and LH in 6/33 patients were above normal. Testosterone in 3/33 was below normal.


CONCLUSIONS
A prepubertal status does not protect the gonads from the harmful effect of chemotherapy, and approximately 87% of male survivors of Hodgkin's disease develop azoospermia or severe oligospermia.
Rafsanjani
Khadijeh A
KA
Department of Pediatric Hematology and Oncology, Iran University of Medical Sciences, Ali Asghar Children's Hospital, Semnan, Iran.
Faranoush
Mohammad
M
Hedayatiasl
Amir A
AA
Vossough
Parvaneh
P
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D053713:Azoospermia / Q000139:chemically induced*; D005640:Follicle Stimulating Hormone / Q000097:blood; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D007492:Iran; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D009845:Oligospermia / Q000139:chemically induced*; D011627:Puberty; D013076:Sperm Count; D017741:Survivors; D013739:Testosterone / Q000097:blood
D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone