title: Sperm counts and endocrinological markers of spermatogenesis in long-term survivors of testicular cancer.
abstract: BACKGROUND
  The objective of this study was to assess markers of spermatogenesis in long-term survivors of testicular cancer (TC) according to treatment, and to explore correlations between the markers and associations with achieved paternity following TC treatment.
  
  
  METHODS
  In 1191 TC survivors diagnosed between 1980 and 1994, serum-follicle stimulating hormone (s-FSH; n=1191), s-inhibin B (n=441), and sperm counts (millions per ml; n=342) were analysed in a national follow-up study in 1998-2002. Paternity was assessed by a questionnaire.
  
  
  RESULTS
  At median 11 years follow-up, 44% had oligo- (<15 millions per ml; 29%) or azoospermia (15%). Sperm counts and s-inhibin B were significantly lower and s-FSH was higher after chemotherapy, but not after radiotherapy (RT), when compared with surgery only. All measures were significantly more abnormal following high doses of chemotherapy (cisplatin (Cis)>850 mg, absolute cumulative dose) compared with lower doses (Cis ≤ 850 mg). Sperm counts were moderately correlated with s-FSH (-0.500), s-inhibin B (0.455), and s-inhibin B : FSH ratio (-0.524; all P<0.001). All markers differed significantly between those who had achieved post-treatment fatherhood and those with unsuccessful attempts.
  
  
  CONCLUSIONS
  The RT had no long-term effects on the assessed markers of spermatogenesis, whereas chemotherapy had. At present, the routine evaluation of s-inhibin B adds little in the initial fertility evaluation of TC survivors.
authors.affiliation: Section of Oncology, Institute of Medicine, University of Bergen, Bergen N-5021, Norway. marianne.brydoy@helse-bergen.no
authors.forename: M
authors.initials: M
authors.lastname: Brydøy
authors.forename: S D
authors.initials: SD
authors.lastname: Fosså
authors.forename: O
authors.initials: O
authors.lastname: Klepp
authors.forename: R M
authors.initials: RM
authors.lastname: Bremnes
authors.forename: E A
authors.initials: EA
authors.lastname: Wist
authors.forename: T
authors.initials: T
authors.lastname: Bjøro
authors.forename: T
authors.initials: T
authors.lastname: Wentzel-Larsen
authors.forename: O
authors.initials: O
authors.lastname: Dahl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007265:Inhibins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D013076:Sperm Count; D013091:Spermatogenesis; D017741:Survivors; D013736:Testicular Neoplasms / Q000097:blood / Q000401:mortality / Q000503:physiopathology*
chemical_list: D015415:Biomarkers; C422364:inhibin B; D007265:Inhibins; D005640:Follicle Stimulating Hormone