Chronic gonadal toxicity in patients with testicular cancer after chemotherapy

Abstract Forty-five patients with disseminated testicular cancer treated with cisplatin, vinblastine and bleomycin ± adriamycin (PVB ± A) were studied to establish the impact of chemotherapy on hormonal and reproductive functions. Data on FSH, LH, testosterone, prolactin, semen analyses and sexual functions were obtained before, during and 1–6 yr after chemotherapy. Mean LH, testosterone and prolactin levels were within normal limits before, during and after chemotherapy. Twenty per cent ( 4 20 ) of the patients revealed pathologically elevated FSH levels due to pretreatment gonadal dysfunction. Germinal aplasia occurred in all patients in the first year after chemotherapy, as 100% rendered azoospermic and 95% showed statistically significant elevated FSH values ( P = 0.001). In the third year after chemotherapy 80% ( 8 10 ) of the patients showed normalization of FSH levels and 100% ( 7 7 ) recovery of sperm production but with a high degree of immotile sperms. Although these results emphasize the restitution of spermatogenesis in the third year after cessation of PVB-regimen, the minority of these patients fathered children, probably due to reduced sperm motility.