Semen analysis for post-orchidectomy patients with testicular cancer before and after chemotherapy or radiotherapy treatment

Abstract

OBJECTIVE: To compare the semen analysis of patients who underwent orchidectomy for testicular cancer before and after chemotherapy or radio therapy treatment. DESIGN: Prospective study. MATERIALS AND METHODS: Seventy-six post-orchidectomy testicular cancer patients who were referred to the Sperm Bank of Human Reproduction Section of Sao Paulo Federal University for semen cryopreservation between 2003 and 2007. Patients were divided in two groups according to teh adjuvant therapy. Group 1: 34 patients with non-seminomatous testicular cancer treated with orchidectomy followed by chemotherapy which consisted of 3 cycles of cisplatin, etoposide and bleomycin. Group 2: 42 patients with seminomatous testicular cancer treated with orchidectomy followed by radiation therapy (2,5Gy). Semen analysis were performed according to World Health Organization manual and Kruger morphology criteria at the time of cryopreservation (pre-treatment) and 3, 6, 9, 12, 24 and 36 months after the end of chemotherapy or radiotherapy treatment. Statistic analysis were performed using SPSS 13.0 for Windows, Student's test and LSD test (α=5%). RESULTS: αNo difference was observed in age (group 1: 26,9;4,2 years and group 2: 26,8;5,1 years).Pre-treatment semen analysis demonstrated a higher percentage of non-progressive motility (grade c) in group 2 (p=0,033).At three months, the percentage of progressive motilty (grades a+b) was higher in group 2 (p=0,039).There were no significant group differences in semen parameters at 6,9,12 and 24 months.At 36 month, semen volume was higher in group2 (p=0,030). In group 1 azoospermia was present in 19 patients (55,9%) at 3 months, 17 (50%) at 6 months,14 (41,2%) at 9 months, 8 patients (23,5%) at 12 month, 6 (17,6%) at 24 months and 4 (11,3%) at 36 months. In group azoospermia was present in 19 (45,2%) patients at 3 months, 10 (23,8%) at 6 months, 9 (21,4%) at 9 months and 5 (11,9%) patients at 12, 24 and 36 months. CONCLUSIONS: Except for semen volume, there were no major differences in semen parameters between chemotherapy (group 1) and radiotherpy group (group 2) at the beginning and at the end of the study. The spermatogenesis recovery is the same 12 months after the end of radiotherapy treatment and 24 months at after chemotherapy treatment.