Post‐treatment Fertility in Patients with Testicular Cancer.: II. Influence of Cis‐platin‐based Combination Chemotherapy and of Retroperitoneal Surgery on Hormone and Sperm Cell Production

Fosså, Sophie D.; Ous, S.; Åbyholm, Thomas; Norman, Nils; Loeb, Mitchell

doi:10.1111/j.1464-410x.1985.tb06426.x

Cited by 90 publications

(21 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The effect of chemotherapy in the com partment inside of the blood-testis barrier was also dem onstrated in the specimens of contralateral biopsies that showed the same amount of germ cell damage (table 1). Moreover, many reports describe the deleterious effects of cytostatic chemotherapy on the intratubular germ cell layer [15,16] as evidenced by testicular biopsies [17], increased follicle-stimulating hormone levels [18,19] and impaired fertility [20].…”

Section: Discussionmentioning

confidence: 99%

Intratesticular Effects of Cisplatin-Based Chemotherapy

Dieckmann¹,

Loy²

1995

Eur Urol

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Intratesticular Effects of Cisplatin-Based Chemotherapy

Dieckmann¹,

Loy²

1995

Eur Urol

View full text Add to dashboard Cite

“…Since most patients with testicular cancer are of a young age, the impact of therapy on sexual function and fertility has become increasingly important. Testicular cancer patients may have a reduced spermatogenesis ('hypospermia') at diagnosis (Hendry et al, 1983;Berthelsen and Skakkebaek, 1984;Cassileth and Steinfeld, 1987;Moynihan, 1987;Nijman et al, 1987;Fossa et al, 1988;Sleijfer et al, 1995) and after orchidectomy (Lampe et al, 1997), and only between 22 and 63% of patients fulfil the definition of normospermia at diagnosis (Hendry et al, 1983;Fossa et al, 1985;Nijman et al, 1987;Lampe et al, 1997). Three disease-associated conditions, local structural abnormalities detected by biopsy of the contralateral testis, the presence of sperm antibodies and endocrine factors, may be responsible (Berthelsen and Skakkebaek, 1984;Guazzieri et al, 1985).…”

mentioning

confidence: 99%

Long-term effects on sexual function and fertility after treatment of testicular cancer

et al. 1999

View full text Add to dashboard Cite

Summary This retrospective study evaluates the types and incidences of sexual disturbances and fertility distress in patients cured from testicular cancer and examines whether there is an effect resulting from different treatment modalities. A self-reported questionnaire was sent to 124 randomly selected patients who were treated at Hanover University Medical School between 1970 and 1993. Ninety-eight patients were included in the study, representing a response rate of 78%. All patients had been in complete remission (CR) for at least 24 months. The median age at diagnosis was 28 years (range 17-44). The median follow-up at the time of study was 12.0 years (range 2.8-25.6). Twenty patients (20%) had been treated for seminomatous and 78 patients (80%) for non-seminomatous germ cell tumours. Treatment included surveillance (7%), primary retroperitoneal lymph node dissection (RPLND) (13%), chemotherapy (CT) (33%), CT + secondary resection of residual retroperitoneal tumour mass (SRRTM) (43%) and infradiaphragmatic radiotherapy (4%). Patients receiving two treatment modalities (CT+SRRTM) reported more frequent an unfulfilled wish for children. Inability of ejaculation was clearly associated with RPLND and SRRTM. Subjective aspects of sexuality, like loss of sexual drive and reduced erectile potential, occurred only in a minority of patients after treatment. No abnormalities were observed concerning the course of pregnancies of partners. In conclusion, sexual dysfunction and infertility are common long-lasting sequelae in testicular cancer survivors affecting approximately 20% of patients. The relative risk for infertility appeared to be elevated for patients treated with the combination of CT+SRRTM. Twenty-one of 40 patients were able to fulfil their wish for children, and no congenital abnormalities were observed in these children.

show abstract

“…Several investigators have shown the time-dependent recovery of spermatogenesis in 60-80% of the patients treated with platin-based chemotherapy (Fosså et al, 1985b;Lampe et al, 1997). The preservation of patients' ejaculatory function thus becomes a major issue for maintenance of fertility.…”

Section: Discussionmentioning

confidence: 99%

Ejaculation in testicular cancer patients after post-chemotherapy retroperitoneal lymph node dissection

et al. 1999

View full text Add to dashboard Cite

SummaryThe purpose of this study was to evaluate fertility after different types of post-chemotherapy retroperitoneal lymph node dissection (RPLND). During 1980During -1994 patients with metastatic testicular cancer underwent post-chemotherapy RPLND with a gradual shift from modified bilateral template RPLND to nerve-sparing RPLND. Modified bilateral template RPLND was done in 92% of the patients operated during 1980-1984 as compared to 16% during 1989-1994. Pre-and post-treatment fertility was assessed by microscopic sperm analysis, determination of serum FSH and information on ejaculation and paternity. There was no significant difference of the survival rates between the three treatment periods. Antegrade ejaculation was preserved in 11% of the patients after modified bilateral template RPLND as compared to 89% after the nerve-sparing operation technique. The median ejaculatory volume decreased post-operatively, serum FSH increased and sperm density remained unchanged. Fifty-six patients attempted fatherhood after their treatment, and 27 fathered at least one child after an observation-time of 55 months, nine of them by assisted fertilization. Patients with initially advanced testicular cancer but limited residual retroperitoneal masses after induction chemotherapy can safely undergo limited post-chemotherapy RPLND as a part of multimodality treatment. After nerve-sparing RPLND antegrade ejaculation is preserved in 89% of the patients though the ejaculatory volume decreases after RPLND. Post-treatment fatherhood can be achieved in at least 50% of the patients attempting paternity.

show abstract

Post‐treatment Fertility in Patients with Testicular Cancer.: II. Influence of Cis‐platin‐based Combination Chemotherapy and of Retroperitoneal Surgery on Hormone and Sperm Cell Production

Cited by 90 publications

References 9 publications

Intratesticular Effects of Cisplatin-Based Chemotherapy

Intratesticular Effects of Cisplatin-Based Chemotherapy

Long-term effects on sexual function and fertility after treatment of testicular cancer

Ejaculation in testicular cancer patients after post-chemotherapy retroperitoneal lymph node dissection

Contact Info

Product

Resources

About