Testicular Function after Combination Chemotherapy for Hodgkin's Disease

Abstract

Fertility was estimated by sperm counts and hormone assays in 8 patients treated for Hodgkin''s disease with at least 6 courses of combination chemotherapy. This consisted of an alkylator (mechlorethamine or cyclophosphamide), a vinca alkaloid (vinblastine or vincristine), procarbazine and prednisone. Azoospermia was found in 7 of the 8 patients on examination 12-29 mo. after termination of chemotherapy. In 1 patient semen quality improved gradually, and a sperm count of 5 million/ml was found at 21 mo. Serum follicle stimulating hormone levels were increased in all but 1 patient who was, nevertheless, azoospermic. The levels of testosterone and luteinizing hormone were generally within normal limits. The germinal tissue is seriously damaged by this type of chemotherapy. The resulting infertility seems to be complete and of long duration. Partial recovery of spermatogenesis may sometimes take place after prolonged unsustained remission.