Sperm DNA integrity in testicular cancer patients

doi:10.1093/humrep/del292

Hum. Reprod. Advance Access originally published online on August 24, 2006
Human Reproduction 2006 21(12):3199-3205; doi:10.1093/humrep/del292

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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Sperm DNA integrity in testicular cancer patients

O. Ståhl¹^,2^,4, J. Eberhard¹^,2, K. Jepson², M. Spano³, M. Cwikiel¹, E. Cavallin-Ståhl¹ and A. Giwercman²

¹ Department of Oncology, Lund University Hospital, Lund ² Fertility Centre and Department of Urology, Scanian Andrology Centre, Malmö University Hospital, Malmö, Sweden and ³ Section of Toxicology and Biomedical Sciences, BIOTEC-MED, ENEA Casaccia Research Center, Rome, Italy

⁴ To whom correspondence should be addressed at: Department of Oncology, Lund University Hospital, SE 221 85 Lund, Sweden. E-mail: olof.stahl{at}med.lu.se

BACKGROUND: We evaluated the impact of testicular germ cellcancer (TGCC), its treatment and length of follow-up on spermDNA integrity. METHODS: In 96 TGCC patients, semen was collectedat specific intervals until 5 years after treatment. Sperm DNAintegrity was assessed by the sperm chromatin structure assay(SCSA, n = 193) and by the terminal deoxynucleotidyl transferase-mediateddUTP nick-end labelling (TUNEL, n = 159) assay. Results wereexpressed as DNA fragmentation index (DFI). Controls comprisedof 278 military conscripts. RESULTS: Post-surgery testicularcancer (TC) patients did not differ from controls. Comparedwith pretreatment values, radiotherapy induced a transient increasein SCSA_DFI (medians: 12 versus 19%; P = 0.03), normalizing after3–5 years. One year or more after therapy, 5/13 (38%)of normozoospermic, irradiated patients had SCSA_DFI >27%compared with 7% of normozoospermic controls (P = 0.002). Morethan two cycles of chemotherapy decreased DFI 3–5 yearspost-therapy (median SCSA_DFI: 12 versus 9.1%, P = 0.02; medianTUNEL_DFI: 11 versus 7.5%, P = 0.03). CONCLUSION: Irradiationincreases sperm DNA damage 1–2 years after treatment,and 38% of irradiated patients with normozoospermia had high(>27%) DNA damage, which may affect the sperm-fertilizingability. TC per se is not associated with an increase of DFI,and DFI is reduced by three or more cycles of chemotherapy.

Key words: chemotherapy/radiotherapy/SCSA/sperm DNA/testicular cancer/TUNEL

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