Recovery from aspermia induced by low-dose radiation in seminoma patients

Abstract

Gonadal dosimetry and spermatogenic activity was monitored in patients given radiation therapy (RT) after unilateral orchiectomy for seminoma. The RT given was, with minor variations, 3200 rad in 16 fractions in four weeks to the para‐aortic and ipsilateral pelvic inguinal lymphatics in order to include the orchiectomy scar. The incidental amount of radiation to the remaining testicle averaged 78.4 ± 7.4 rad and ranged from 32–178 rad as determined by thermoluminescent dosimetry. Induction of aspermia was documented in ten out of 14 patients who received over 65 rad to the gonad. At lower doses, aspermia may not have occurred or was of short duration. Recovery of sperm in the semen occurred in 12 patients within 30–80 weeks after start of treatment. The data suggest that the time of recovery may be dose dependent within the range of 19–148 rad. During the period of recovery, patients with oligospermic semen may be fertile and should be so advised.

Donor Sertoli cells transplanted into irradiated rat testes stimulate partial recovery of endogenous spermatogenesis

“…The occasional observation of isolated spermatogonia in testicular biopsies at relatively long times after chemotherapy treatment (Kreuser et al 1989) and the spontaneous recovery of spermatogenesis in some men after several years of radiation or chemotherapy-induced azoospermia (Hahn et al 1982, Pryzant et al 1993, Gerdprasert et al 2002 indicate that there may indeed be a reversible block to differentiation in humans. Sertoli cell transplantation may still be useful for treatment of infertility induced by radiation or antineoplastic drugs to reverse this block and provide additional niches for co-transplanted stem cells.…”

Clinical Potential and Putative Risks of Fertility Preservation in Children Utilizing Gonadal Tissue or Germline Stem Cells

“…2). In the spermatogenic epithelium of humans, re-colonization can be detected 9 -18 mo after dose 1 Gy and more than 4 y after dose 10 Gy (30,31). In humans and primates where spermatozoa may be isolated in testicular biopsies, it has been shown that recovery after severe damage occurs only focally in a few seminiferous tubules.…”

Gonadal function in men with chronic illness

“…After single dose exposure, complete recovery occurs at 9-18 months after less than 100 cGy, 30 months after 200-300 cGy and 5 or more years after 400-600 cGy (Shalet, 1983). The recovery is longer after fractionated doses (Hahn et al, 1982;Meistrich & van Beek, 1990). The effects of radiation on human DNA is not entirely clear.…”

“…Although there is no definitive proof in man, cytogenetic studies show that radiation is a potential mutagen, and the question remaining is at what dose these effects occur (Meistrich & van Beek, 1990). Radiation effects on the testis have been described in men receiving treatment for seminoma (Hahn et al, 1982) and inverted Y irradiation for Hodgkin's disease (Shalet, 1983). There is also scatter of irradiation from other radiotherapeutic procedures in the vicinity of the testis and shielding is therefore important (Meistrich & van Beek, 1990).…”