Inhibin B concentration is predictive for long-term azoospermia in men treated for testicular cancer.

Sigrid Isaksson, Jakob Eberhard, Olof Ståhl, Eva Cavallin-Ståhl, G Cohn-Cedermark, S Arver, Yvonne Giwercman, Aleksander Giwercman

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskriftPeer review

10 Citeringar (SciVal)

Sammanfattning

Azoospermia is a serious potential side effect following treatment for testicular cancer (TC). Our purpose was to examine possible predictors of long-term azoospermia in TC survivors. Ejaculates and blood samples were obtained from 217 patients at post-orchidectomy but before further treatment (T0 ) and/or at one or more of the time points 6, 12, 24, 36-60 months after treatment (T6 , T12 , T24 , T36-60 ). All patients delivered ejaculates at T36-60 , of which 117 also had confirmed presence of spermatozoa in the ejaculate at T0 , enabling longitudinal analyses. Types of therapy, cryptorchidism and Inhibin B before and after treatment were evaluated in relation to risk of azoospermia at T36 . Inhibin B levels at T6 , T12 and T24 were predictors of azoospermia at T36 with cut-off levels at 49.7, 55.9 and 97.8 ng/L respectively (sensitivity 100%, specificity 57-78%). The frequency of azoospermia in all patients at T36-60 was 7.8% (95% CI 4.9-12%). As compared to surveillance patients, only those receiving >4 cycles of chemotherapy or ≥4 cycles of chemotherapy + radiotherapy (RT) had increased risk of long-term azoospermia (63% vs. 4.4% in the surveillance group; p = 0.0018). In conclusion, all patients with sperm production at post-orchidectomy but before further treatment and Inhibin B >56 ng/L 12 months after treatment had sperm production 3 years post-treatment. Eight per cent of TC survivors had azoospermia 3-5 years post-treatment, with highest risk in those receiving >4 cycles of chemotherapy or ≥4 cycles of chemotherapy in combination with RT.
Originalspråkengelska
Sidor (från-till)252-258
TidskriftAndrology
Volym2
Utgåva2
DOI
StatusPublished - 2014

Ämnesklassifikation (UKÄ)

  • Reproduktionsmedicin och gynekologi

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