Inhibin B concentration is predictive for long‐term azoospermia in men treated for testicular cancer. (12th February 2014)

• Record Type: Journal Article
• Authors: Isaksson, S.; Eberhard, J.; Ståhl, O.; Cavallin‐Ståhl, E.; Cohn‐Cedermark, G.; Arver, S.; Lundberg Giwercman, Y.; Giwercman, A.
• Is Part Of: Andrology. Volume 2:Number 2(2014)
• Page Start: 252
• Page End: 258
• Publication Date: 2014-02-12
• Subjects: Andrology -- Periodicals; 616.65
• DOI: 10.1111/j.2047-2927.2014.00182.x
• Languages: English
• ISSNs: 2047-2919

Abstract

<abstract abstract-type="main" id="andr182-abs-0001"> <title>Summary</title> <p>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 (T<sub>0</sub>) and/or at one or more of the time points 6, 12, 24, 36–60 months after treatment (T<sub>6</sub>, T<sub>12</sub>, T<sub>24</sub>, T<sub>36–60</sub>). All patients delivered ejaculates at T<sub>36–60</sub>, of which 117 also had confirmed presence of spermatozoa in the ejaculate at T<sub>0</sub>, enabling longitudinal analyses. Types of therapy, cryptorchidism and Inhibin B before and after treatment were evaluated in relation to risk of azoospermia at T<sub>36</sub>. Inhibin B levels at T<sub>6</sub>, T<sub>12</sub> and T<sub>24</sub> were predictors of azoospermia at T<sub>36</sub> 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 T<sub>36–60</sub> 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; <italic>p</italic> = 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.</p> </abstract>