Sperm count in Swedish clinical stage I testicular cancer patients following adjuvant treatment

Abstract

Background: Little is known regarding sperm production following adjuvant treatment in testicular cancer (TC) clinical stage I (CS I) patients.Patients and methods: A total of 182 TC patients aged 18-50 years were prospectively included during 2001-2006 at any given time within 5 years of orchiectomy. Semen samples were delivered postorchiectomy but before further treatment, 6, 12, 24, 36 and 60 months (T 0 -T 60 ) after completed therapy. Total sperm number (TSN) and sperm concentration (SC) were used as measurements of testicular function. Four groups according to treatment modality were identified; Radiotherapy; To a total dose of 25.2 Gy to the infradiaphragmal paraaortic and ipsilateral iliac lymph nodes (RT, N ¼ 70), one cycle of adjuvant BEP (bleomycin, etoposide, cisplatin, 5 day regimen) (BEP, N ¼ 62), one cycle of adjuvant carboplatin AUC 7 (Carbo, N ¼ 22), and patients managed by surveillance (SURV, N ¼ 28).Results: In the cross-sectional analysis, a significant but transient drop in mean TSN and mean SC (T 0 -T 60 ) was seen at T 6 after radiotherapy. Apart from a significant increase in mean SC at T 12 compared with baseline, no significant differences were observed in the other treatment groups. In 119 patients delivering 3 or more samples, values in TSN and SC were rather stable over time. Azoospermic patients (N ¼ 11) were observed in most treatment groups except for in the BEP group. During followup, one azoospermic patient belonging to the Carbo group became normospermic. Conclusions:No clinically significant long-term effect on TSN or SC associated with adjuvant treatment in TC CSI patients was found. However, as patients may have low sperm counts before orchiectomy as well as after adjuvant treatment, we offer sperm banking before orchiectomy as assisted reproductive measures may be necessary regardless of treatment given.

The outcome of IVF/ICSI cycles in male cancer patients: retrospective analysis of procedures from 2004 to 2018

“…Weibring et al . 38 reported similar observations, but further noted that semen quality improves 12 months after the end of treatment. Di Bisceglie et al .…”

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“…A prospective study of clinical stage 1 TC patients showed that adjuvant chemotherapy was not associated with a long-term effect on sperm concentration. 23 The mean sperm concentrations at 12 months after completion of treatment were 43 million/mL in the surveillance group, 33 million/mL in the one cycle of carboplatin group and 31 million/mL in the one cycle of BEP group.…”

The effect of gonadal and extragonadal malignant cancers on sperm quality

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