Male reproductive health after childhood cancer.
OBJECTIVE
Twenty-five male patients were investigated to elucidate the correlation of semen parameters and other related parameters in the assessment of spermatogenesis after childhood cancer treatment.


METHODS
Evaluation of given cancer treatment, anthropometric and testicular size measurements, semen analysis, and measurement of gonadotrophins, testosterone, sex hormone-binding globulin (SHBG), and inhibin B were performed according to a protocol.


RESULTS
Median (range) sperm concentration (SC) was 35.5 (0-273)x10(6)/mL, and percentage of motile sperm 56 (0-86)%. Testicular size (r=0.73, p<0.001) and the level of inhibin B (r=0.66, p<0.001) correlated strongly to SC. SC correlated negatively to FSH (r=0.46, p=0.03). Only testicular size predicted SC significantly (p=0.03). Inhibin B showed highest area under ROC curve (0.83, 95%CI 0.67-0.99) in showing SC<20x10(6)/mL. Body mass index (BMI) did not correlate with SC, but negative correlation between BMI and SHBG was found (r=-0.41, p=0.04).


CONCLUSIONS
Although semen analysis is a useful instrument for fertility assessment in men, it is often difficult to get these samples from childhood cancer survivors. Thus, indirect methods are needed in prediction of possible sperm count impairment in postpubertal adolescents after cancer treatment. When combined with the data on testicular size and follicle-stimulating hormone (FSH) level, inhibin B gives valuable addition to the estimations of spermatogenesis.
Lähteenmäki
P M
PM
Department of Pediatrics, Turku University Central Hospital, Turku, Finland. paivi.lahteenmaki@tyks.fi
Arola
M
M
Suominen
J
J
Salmi
T T
TT
Andersson
A M
AM
Toppari
J
J
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005298:Fertility; D005640:Follicle Stimulating Hormone / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007265:Inhibins / Q000097:blood; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D013091:Spermatogenesis / Q000187:drug effects / Q000528:radiation effects; D013737:Testis / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D013739:Testosterone / Q000097:blood; D014463:Ultrasonography
C422364:inhibin B; D013739:Testosterone; D007265:Inhibins; D005640:Follicle Stimulating Hormone