Hum. Reprod. Advance Access originally published online on September 22, 2006
Human Reproduction 2006 21(11):2882-2889; doi:10.1093/humrep/del167
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Effect of chemo- or radiotherapy on sperm parameters of testicular cancer patients
1 Laboratory of Seminology and Immunology of Human Reproduction, Department of Medical Pathophysiology, Policlinico ‘Umberto I’ and 2 Department of Experimental Medicine, University of Rome ‘La Sapienza’, Rome, Italy
3 To whom correspondence should be addressed at: Laboratory of Seminology and Immunology of Human Reproduction, Policlinico ‘Umberto I’, University of Rome ‘La Sapienza’, 00161 Rome, Italy. E-mail: loredana.gandini{at}uniroma1.it
BACKGROUND: The aims of our study were to investigate the short- and long-term effects of chemo- or radiotherapy on spermatogenesis in patients with testicular cancer and to establish any correlation between pre-therapy sperm parameters, histotype and treatment type/intensity and the progress of spermatogenesis during the post-therapy period. METHODS: We evaluated 166 patients affected by testicular cancer, who cryobanked about 1 month after the removal of the cancerous testis and before beginning chemo- (CH group; n = 71) or radiotherapy (RT group; n = 95). RESULTS: For the CH group, there was a statistically significant decrease in sperm parameters, which was most significant 3 months after the end of chemotherapy. For the RT group, this decrease was most relevant 6 months after the end of radiotherapy. Two years after therapy, 3% of the CH group and 6% of the RT group remained azoospermic. To evaluate whether spermatogenesis recovery is a function of baseline semen quality, we divided each group into two subgroups by pre-therapy total sperm count (A, <40 x 106/ejaculate; B, 
40 x 106/ejaculate). At t24, subgroup A of both the CH and RT groups showed improved sperm parameters over the baseline, whereas subgroup B for both CH and RT groups showed a return of sperm parameters to those of baseline values. CONCLUSIONS: In conclusion, the recovery of spermatogenesis after chemo- or radiotherapy in our group of testicular cancer patients was not a function of pre-therapy sperm parameter quality. Cryopreservation of sperm before performing such therapy is therefore imperative.
Key words: chemotherapy/radiotherapy/semen quality/testicular cancer
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