Fertility in male patients with newly diagnosed Hodgkin´s lymphoma



Year of publication 2008
Type Conference abstract
MU Faculty or unit

Faculty of Medicine

Description Introduction: The prognosis of pts with Hodgkins lymphoma (HL) has improved over the last decades. Depending on stage of disease, more than 80% of pts can be cured, but they are at higher risk for secondary malignancies and other late effects such as infertility. Even if the most HL pts are young, several studies have shown they have inadequate sperm quality even before cytostatic treatment. Material and methods: We evaluated semen and hormonal analysis in newly diagnosed pts with HL to demonstrate the fertility status at the time of diagnosis. We examined a total of 80 male pts, with median age 26 yrs (16-42). Most pts were in early clinical stage (33 pts; 41%), followed by the group of pts in advanced st. (28 pts; 35%) and in intermediate st. (19 pts; 24%). The semen samples parameters were compared with a reference set of 89 healthy men interested in sperm donation, with median age of 23 yrs (18-35). The t-test was used for statistical evaluations. Results: In 95% (N=76) of the pts, inadequate semen quality was established, with low sperm cell count and/or defective sperm morphology. Severe defects such as azoospermia and OAT were found in 14% (n=11) and 26% (n=21) pts respectively. In other pts, combined damages such as asthenospermia in 14% (n=11) and asthenoteratospermia in 41% (n=33) were identified. Normal findings were only established in 4 pts. In comparison with the control set of healthy men, statistically significant differences were found (p=0,05) in the average concentration (31,6 vs 55,7 mil/ml) and in the presence of progressively motile sperm cells (14,2% vs 43,6%). No deviation from the normal reference range of serum levels of FSH, LH and testosterone could be established in anyone of the pts. Conclusions: The majority of pts in our study had inadequate semen quality before treatment. The underlying mechanism is still unknown. Suspected factors include damage in the germinal epithelium, disturbance in the hypothalamic-hypophysial axis and the impact of the disease-related cytokines on spermatogenesis.

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