Simon J Howell Md Mrcp and Stephen M Shalet Md Frcp

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Pretreatment Testicular Dysfunction



Genetic Damage Following Cytotoxic Therapy Protection of Testicular Function During Cancer

Treatment Summary References

It has been recognized for many years that testicular dysfunction is relatively common after treatment with cytotoxic chemotherapy and radiotherapy. The number of malignancies which are potentially treatable has increased during the last few decades. This increase, coupled with the improving long-term survival rates of many cancers, has meant that the number of surviving patients who have received cytotoxic therapy or radiotherapy is growing rapidly, and cancer treatment is becoming an increasingly common cause of acquired testicular dysfunction.

Spermatogenesis impairment has been demonstrated in patients with various malignancies before treatment. in addition, damage to the germinal epithelium resulting in oligospermia or azoospermia is a recognized consequence of certain chemotherapeutic agents and radiotherapy, and there is also evidence of Leydig cell dysfunction after treatment. Testicular damage is drug specific and dose related (1-4). The chance of recovery of spermatogenesis after the cytotoxic insult and the extent and speed of recovery are related to the agent used and the dose received. it has also been suggested that the germinal epithelium of the adult testis is more susceptible to damage than that of the prepubertal testis (5), implying that patient age or testis maturation at the time of

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