SPERM ANALYSIS IN TESTICULAR CANCER: PRE- AND POST- TREATMENT FINDINGS

Because of the 90% cure rate achieved in testicular cancer with cisplatinum-based chemotherapy (CT) combinations, long term survival has lead to concerns about gonadal functions. In order to investigate the effects of testicular cancer and cisplatinum-based CT combinations on sperm analysis, 55 patients with orchiectomy were evaluated retrospectively. Patients' median age was 26 (16-45), median follow up was 28 (4-76) months and the median time to current analysis 15 (4-34) months. There were 32 stage I, 17 stage II, 2 stage III, 4 stage IV patients. The azooligospermia ratios were 58% among the 38 patients with pre-CT sperm analysis, 100% among the 31 patients with post-CT sperm analysis, 62% among the 34 patients with current sperm analysis. Mean sperm concentration, % motility, and % normal morphology values were pre-CT 19.64±20.87, 14.13±22.82, 36.82±38.65; post CT 0.29±1.44, 0,0; current period 17.20±24.69, 20.69±25.22, 37.04±41.07 respectively. The median time for sperm count recovery was 18 (7-29) months. Although the normospermia ratio was 42% among the patients whose follow up was greater then 18 months. Although it was not statistically significant by logistic regression analysis, pretreatment normospermia ratio was higher in stage I patients than the other stages (p=0.07). Age, stage and CT type did not affect the current period sperm counts. Sperm counts are not adequate for evaluating gonadal functions; however, these results have shown that some chemotherapy-related damage can be restored eventually.