Hormone and Sperm Analyses after Chemo- and Radiotherapy in Childhood and Adolescence

Rendtorff, Rosa; Hohmann, Cynthia; Reinmuth, Simone; Müller, Andreas; Dittrich, Ralf; Beyer, M; Wickmann, L.; Keil, Thomas; Henze, Günter; Borgmann‐Staudt, Anja

doi:10.1055/s-0030-1249658

Cited by 39 publications

(41 citation statements)

References 17 publications

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“…In the few studies of childhood cancer survivors [8,9,20] AMH values are markedly lower compared with aged-matched normative data [6,24]. The AMH levels in our CLSs decreased along treatment gonadotoxicity, and almost all survivors after ''high-toxic'' treatment had critically low values.…”

Section: Discussioncontrasting

confidence: 54%

“…Eleven % of our male CLSs were considered to be infertile. In other studies among survivors treated for several types of childhood cancer, azospermia was found in about 30% of the survivors, and elevated FSH levels were observed in approximately every third survivor [20,21]. Elevated FSH is generally viewed to reflect reduced spermatogenesis, and may on a group level together with a single sperm count be useful to screen for possibility of future parenthood.…”

Section: Discussionmentioning

confidence: 97%

“…Previous studies have been inconclusive as to this issue [20,21], although Green et al [23] demonstrated a higher chance of parenthood in male childhood cancer survivors treated at age 0-4 years compared to age 15-20 years. Neither could we demonstrate any significant difference in levels of FSH when comparing patients treated before or after 1985.…”

Section: Discussionmentioning

confidence: 98%

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Gonadal function and parenthood 20 years after treatment for childhood lymphoma: A cross‐sectional study

Hamre

Kiserud

Ruud

et al. 2011

Pediatric Blood & Cancer

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BackgroundGonadal function decades after treatment for childhood lymphoma (CL) is not well described. This cross‐sectional study had two aims: (1) describe long‐term gonadal function and fertility in childhood lymphoma survivors (CLSs), and (2) explore anti‐Mullerian hormone (AMH) as a measure of ovarian function in CLSs.ProcedureSeventy‐four male and 62 female CLSs participated in a survey consisting of a questionnaire, clinical examination, and blood/semen analysis. Prior treatment was categorized according to gonadotoxicity. Hypogonadism was determined by levels of gonadal hormones based on luteinizing hormone, follicle‐stimulating hormone, testosterone (males), AMH (females <40 years), and menstrual status. Fertility was explored according to pregnancies achieved, semen analysis, and AMH.ResultsHypogonadism was observed in 7 of 66 males (11%). Seven of 64 males (11%) were categorized as infertile. Nine of 45 females <40 years (20%) were at risk to develop premature ovarian failure (POF). Twenty of 45 females (44%) showed low‐AMH levels indicating decreased fertility. Four “critically low” females reported pregnancies within the preceding 2 years. Sixty‐four percent of the males and 93% of the females attempting parenthood had been successful (P = 0.01). Hypogonadism and low‐AMH were related to treatment burden.ConclusionTwenty years after treatment of CL, female CLSs' attempts of pregnancy initiation are mostly successful, while males seem at higher risk of infertility. Hypogonadism is a problem in 10% of the male CLSs. Based on AMH levels, POF is a risk in 20% of the female CLSs. The clinical significance of AMH reflecting true probability of fertility needs further research in cancer survivors. Pediatr Blood Cancer 2012;59:271–277. © 2011 Wiley Periodicals, Inc.

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Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 98%

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Gonadal function and parenthood 20 years after treatment for childhood lymphoma: A cross‐sectional study

Hamre

Kiserud

Ruud

et al. 2011

Pediatric Blood & Cancer

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“…3 Impaired fertility is a well-known side effect after HSCT in childhood and adolescence but studies in the field are often limited by small numbers of patients in the various groups. [21][22][23] A recent study on the recovery of spermatogenesis after HSCT reported that spermatozoa were found in sperm fluid analyses in 58 of 217 males (27%) after a median follow-up period of 4.5 years. 24 A recent review of paediatric HSCT reported that impaired fertility was present in nearly all females treated with conditioning protocols including BU.…”

Section: Discussionmentioning

confidence: 99%

“…In males, however, pre-pubertal therapy was found to increase the risk for infertility, which is inconsistent with findings of other recent studies. 21 The fact that TBI was a significant risk factor for infertility in males is not surprising given that impaired sperm production in the form of temporary oligospermia occurs after radiotherapy at dosages as low as 0.1 Gy. This azoospermia may resolve over a period of years.…”

Section: Discussionmentioning

confidence: 99%

Fertility after allogeneic haematopoietic stem cell transplantation in childhood and adolescence

Borgmann‐Staudt

Rendtorff

Reinmuth

et al. 2011

Bone Marrow Transplant

158

123

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Infertility is a major late effect in patients receiving haematopoietic stem cell transplantation (HSCT). The aim of this study was to determine the proportion of patients having fertility impairment after allogeneic HSCT in childhood/adolescence and to identify the potential risk factors. Treatment and fertility data of paediatric patients with malignant and non-malignant diseases treated with allogeneic HSCT between 2000 and 2005 were collected from seven European centres. Data were obtained for 138 female and 206 male patients after a median follow-up of 6 years (range 3-12). The patients' median age was 13 years (range 4-28) at the time of years at the time of the enquiry. Seven children were born to the overall group, all at term and healthy. Fertility impairment was suspected in 69% males and 83% females. Start of treatment at age X13 years was a risk factor in females (odds ratio (OR) 4.7; 95% confidence interval (CI), 1.5 to 14.9), whereas pre-pubertal therapy was a risk factor in males (OR 0.4; 95% CI, 0.2 to 0.8). The major treatment-related risk factors were BU in females (OR 47.4; 95% CI, 5.4 to 418.1) and TBI in males (OR 7.7; 95% CI, 2.3 to 25.4). In light of the significant proportion of HSCT patients reviewed with impaired fertility, fertility conservation procedures should be considered for all patients undergoing HSCT, particularly those receiving TBI or BU-based preparative regimens.

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Desire for biological parenthood and patient counseling on the risk of infertility among adolescents and adults with hemoglobinopathies

Radauer-Plank

Diesch-Furlanetto

Schneider

et al. 2023

Pediatric Blood & Cancer

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Background Both diagnosis and treatment of hemoglobinopathies have been associated with an increased risk of fertility impairment. German guidelines recommend annual monitoring of fertility parameters to enable early detection of fertility impairment and/or to offer fertility preservation (FP) when indicated. We explored the general desire for parenthood, the frequency of recalling fertility counseling and testing, and the utilization of FP in adolescents and adults with hemoglobinopathies. Procedure In a cross‐sectional study, patients aged 12–50 years, treated in Germany, Austria, or Switzerland, were surveyed on fertility‐related aspects. Medical data, including fertility testing results, were collected from patient records. Results Overall, 116/121 eligible patients, diagnosed with sickle cell disease (70.7%), thalassemia (27.6%), or other hemoglobinopathy (1.7%), participated in our study (57.8% female, median age 17.0 years, range 12–50 years). All participants required treatment of the underlying hemoglobinopathy: 68.1% received hydroxyurea, 25.9% required regular blood transfusions, and 6.0% underwent hematopoietic stem cell transplantation (HSCT). Most patients (82/108, 75.9%) stated a considerable to strong desire for (future) parenthood, independent of sex, education, diagnosis, or subjective health status. Fertility counseling was only recalled by 32/111 patients (28.8%) and least frequently by younger patients (12–16 years) or those treated with regular blood transfusions or hydroxyurea. While fertility testing was documented for 59.5% (69/116) in medical records, only 11.6% (13/112) recalled previous assessments. FP was only used by 5.4% (6/111) of patients. Conclusion Most patients with hemoglobinopathies wish to have biological children, yet only few recalled fertility counseling and testing. Adequate patient counseling should be offered to all patients at risk for infertility.

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Hormone and Sperm Analyses after Chemo- and Radiotherapy in Childhood and Adolescence

Cited by 39 publications

References 17 publications

Gonadal function and parenthood 20 years after treatment for childhood lymphoma: A cross‐sectional study

Gonadal function and parenthood 20 years after treatment for childhood lymphoma: A cross‐sectional study

Fertility after allogeneic haematopoietic stem cell transplantation in childhood and adolescence

Desire for biological parenthood and patient counseling on the risk of infertility among adolescents and adults with hemoglobinopathies

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