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.<p> <p>Methods: In 1191 TC survivors diagnosed between 1980 and 1994, serum-follicle stimulating hormone (s-FSH; n ¼ 1191), s-inhibin B (n ¼ 441), and sperm counts (millions per ml; n ¼ 342) were analysed in a national follow-up study in 1998–2002. Paternity was assessed by a questionnaire.<p> <p>Results: At median 11 years follow-up, 44% had oligo- (o15 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)4850 mg, absolute cumulative dose) compared with lower doses (Cis p850 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 Po0.001). All markers differed significantly between those who had achieved post-treatment fatherhood and those with unsuccessful attempts.<p> <p>Conclusion: 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