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Inhibin B concentration is predictive for long-term azoospermia in men treated for testicular cancer.

Isaksson, Sigrid LU ; Eberhard, Jakob LU ; Ståhl, Olof LU ; Cavallin-Ståhl, Eva LU ; Cohn-Cedermark, G ; Arver, S ; Giwercman, Yvonne LU and Giwercman, Aleksander LU (2014) In Andrology 2(2). p.252-258
Abstract
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 (T0 ) and/or at one or more of the time points 6, 12, 24, 36-60 months after treatment (T6 , T12 , T24 , T36-60 ). All patients delivered ejaculates at T36-60 , of which 117 also had confirmed presence of spermatozoa in the ejaculate at T0 , enabling longitudinal analyses. Types of therapy, cryptorchidism and Inhibin B before and after treatment were evaluated in relation to risk of azoospermia at T36 . Inhibin B levels at T6 , T12 and T24 were... (More)
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 (T0 ) and/or at one or more of the time points 6, 12, 24, 36-60 months after treatment (T6 , T12 , T24 , T36-60 ). All patients delivered ejaculates at T36-60 , of which 117 also had confirmed presence of spermatozoa in the ejaculate at T0 , enabling longitudinal analyses. Types of therapy, cryptorchidism and Inhibin B before and after treatment were evaluated in relation to risk of azoospermia at T36 . Inhibin B levels at T6 , T12 and T24 were predictors of azoospermia at T36 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 T36-60 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; p = 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. (Less)
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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Andrology
volume
2
issue
2
pages
252 - 258
publisher
Wiley-Blackwell
external identifiers
  • pmid:24519955
  • wos:000331696100013
  • scopus:84894355738
  • pmid:24519955
ISSN
2047-2927
DOI
10.1111/j.2047-2927.2014.00182.x
language
English
LU publication?
yes
id
000bc34b-a005-4963-bf4c-2a0c3cca3728 (old id 4334801)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24519955?dopt=Abstract
date added to LUP
2016-04-01 10:08:59
date last changed
2022-03-12 02:33:27
@article{000bc34b-a005-4963-bf4c-2a0c3cca3728,
  abstract     = {{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 (T0 ) and/or at one or more of the time points 6, 12, 24, 36-60 months after treatment (T6 , T12 , T24 , T36-60 ). All patients delivered ejaculates at T36-60 , of which 117 also had confirmed presence of spermatozoa in the ejaculate at T0 , enabling longitudinal analyses. Types of therapy, cryptorchidism and Inhibin B before and after treatment were evaluated in relation to risk of azoospermia at T36 . Inhibin B levels at T6 , T12 and T24 were predictors of azoospermia at T36 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 T36-60 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; p = 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.}},
  author       = {{Isaksson, Sigrid and Eberhard, Jakob and Ståhl, Olof and Cavallin-Ståhl, Eva and Cohn-Cedermark, G and Arver, S and Giwercman, Yvonne and Giwercman, Aleksander}},
  issn         = {{2047-2927}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{252--258}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Andrology}},
  title        = {{Inhibin B concentration is predictive for long-term azoospermia in men treated for testicular cancer.}},
  url          = {{http://dx.doi.org/10.1111/j.2047-2927.2014.00182.x}},
  doi          = {{10.1111/j.2047-2927.2014.00182.x}},
  volume       = {{2}},
  year         = {{2014}},
}