Gonadal function, testicular histology, and meiosis following cyclophosphamide therapy in patients with nephrotic syndrome

Abstract

Gonadal function, histology, and meiosis were studied in patients after puberty who had received cyclophosphamide in the treatment of nephrotic syndrome. Four males with minimal lesion nephrotic syndrome received cyclophosphamide, 2 to 4 mg/kg/24 hr, during periods ranging from 49 to 60 days and had normal semen at 15 3/12 to 22 3/12 years of age. Four males who received cyclophosphamide, 2 to 5 mg/kg/24 hr, during 89 to 489 days were azoospermic at 15 6/12 to 21 11/12 years of age. Plasma testosterone levels were normal in both groups. LH and FSH levels were elevated in the azoospermicgroup. Light and electron microscopy and meiotic analysis of testicular tissue were normal in two normospermic patients tested. Germinal cells were absent but Leydig and Sertoli cells were present in three azoospermic patients tested. No neoplasia was observed. Two preadolescent and two postadolescent males received 64 to 129 mg/kg of cyclophosphamide during 14 to 45 days and have since fathered normal children. One preadolescent female received 182 mg/kg of cyclophosphamide during 49 days and later bore a normal child. Two preadolescent females who died of complications of their nephrotic syndrome during childhood after courses of cyclophosphamide had normal preadolescent ovaries.