title: Impact of chemotherapy and radiotherapy for testicular germ cell tumors on spermatogenesis and sperm DNA: a multicenter prospective study from the CECOS network.
abstract: OBJECTIVE
  To determine the consequences of adjuvant testicular germ cell tumor treatment (TGCT) on sperm characteristics and sperm DNA, and to evaluate the predictors of sperm recovery.
  
  
  METHODS
  Multicenter prospective longitudinal study of patients analyzed before treatment and after 3, 6, 12, and 24 months.
  
  
  METHODS
  University hospitals.
  
  
  METHODS
  One hundred twenty-nine volunteer TGCT patients and a control group of 257 fertile men.
  
  
  METHODS
  Routine semen analyses, sperm DNA, and chromatin assessments.
  
  
  METHODS
  Comparisons of mean sperm characteristics before and after treatment, with sperm recovery analyzed by the Kaplan-Meier method.
  
  
  RESULTS
  The quantitative and qualitative sperm characteristics decreased after treatment, with lowest values at 3 and 6 months and with variations according to treatment type. The mean total sperm count recovered to pretreatment values at 12 months after treatment after two or fewer bleomycin, etoposide, and cisplatin (BEP) cycles, but not after radiotherapy or more than two BEP cycles. Only the treatment modalities and pretreatment sperm production were related to recovery of the World Health Organization reference sperm values. An increased proportion of patients had elevated high sperm DNA stainability at 6 months after radiotherapy.
  
  
  CONCLUSIONS
  Adjuvant treatments for testicular germ cell tumor have drastic effects on spermatogenesis and sperm chromatin quality. These new data on both the recovery period according to treatment modalities and the post-treatment chromatin status of sperm are useful tools for counseling patients wishing to conceive.
authors.affiliation: Fédération Française des Centre d'Étude et de Conservation des Œufs et du Sperme Humains (CECOS), Paris, France. bujan.l@chu-toulouse.fr
authors.forename: Louis
authors.initials: L
authors.lastname: Bujan
authors.forename: Marie
authors.initials: M
authors.lastname: Walschaerts
authors.forename: Nathalie
authors.initials: N
authors.lastname: Moinard
authors.forename: Sylvianne
authors.initials: S
authors.lastname: Hennebicq
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Saias
authors.forename: Florence
authors.initials: F
authors.lastname: Brugnon
authors.forename: Jacques
authors.initials: J
authors.lastname: Auger
authors.forename: Isabelle
authors.initials: I
authors.lastname: Berthaut
authors.forename: Ethel
authors.initials: E
authors.lastname: Szerman
authors.forename: Myriam
authors.initials: M
authors.lastname: Daudin
authors.forename: Nathalie
authors.initials: N
authors.lastname: Rives
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage; D004247:DNA / Q000187:drug effects / Q000528:radiation effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005602:France; D006801:Humans; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D011446:Prospective Studies; D011878:Radiotherapy / Q000009:adverse effects; D013091:Spermatogenesis / Q000187:drug effects* / Q000528:radiation effects*; D013094:Spermatozoa / Q000737:chemistry / Q000187:drug effects / Q000378:metabolism / Q000528:radiation effects; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D055815:Young Adult
chemical_list: D001761:Bleomycin; D005047:Etoposide; D004247:DNA; D002945:Cisplatin
keywords: Adverse effects; BEP chemotherapy; radiotherapy; sperm chromatin; spermatogenesis