Male Fertility of Kidney Transplant Patients With One to Ten Years of Evolution Using a Conventional Immunosuppressive Regimen

Abstract

The reproductive functions and hormone serum levels of 55 male kidney transplant recipients were assessed. Patients underwent peritoneal dialysis before transplantation and were given immunosuppressive therapy afterward for 1 to 10 years. Spermatobioscopies were performed, and serum urea, creatinine, luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), and testosterone (T) levels were determined. Average serum urea and creatinine levels were 54.6+/-1.4 and 3+/-1.3 mg/dL, respectively. The average serum hormone levels were 3.2+/-2 mIU/mL (LH), 6.3+/-1.7 mIU/mL (FSH), 11.7+/-1.5 ng/mL (PRL), and 23+/-1.4 pg/mL (T). Libido reduction was reported in 88% of patients within 8 months following transplantation. Normozoospermia was seen in 47.3% of the patients, asthenozoospermia in 18.2% oligozoospermia in 14.5%, while oligoteratozoospermia, asthenoteratozoospermia, oligoasthenozoospermia, oligoasthenoteratozoospermia, and azoospermia were seen in the rest. Twenty-six patients procreated one or more children after transplantation; 36.6% of those children were premature but nonetheless healthy. No association existed between the post-transplant period and urea or creatinine levels. Significant differences were found when LH levels and sperm motility were assessed. Also, statistically significant differences were found when duration of dialysis, FSH levels, sperm counts, morphology, and motility between posttransplant fertile and infertile patients were correlated. In conclusion, there was an adequate recovery of sexual and reproductive functions in most patients subjected to kidney transplantation and conventional immunosuppressants.

Effect of Uremia on Semen Quality and Reproductive Function in Humans

“…In these patients, the semen analysis typically showed a decreased volume of ejaculate, oligo-or complete azoospermia and a low percentage of motile sperms. Besides, the presence of orchiatrophy in the advanced stage of uremia has been also reported [12]. The spermatobioscopy results revealed that azoospermia and oligozoospermia were present in 50% of the patients.…”

Impact of Kidney Transplantation on Reproductive Hormone Levels in Males: A Longitudinal Study

“…The normalization of LH and a tendency towards increasing testosterone levels after kidney transplantation suggests that Leydig cell impairment is rapidly resolved by kidney transplantation. However, sperm quality measured as sperm count, motility, and morphology does not seem to improve as fast as hormone levels [6, 15, 16]. Indeed, there are reports of continuously improved sperm quality during 2 years after transplantation and reports of transplanted men not regaining the sperm motility function [17].…”

Sexual and Reproductive Function in Chronic Kidney Disease and Effect of Kidney Transplantation

“…The sex hormone profile tends to normalize; plasma testosterone and follicle stimulating hormone levels increase; and luteinizing hormone levels which may be high in dialysis patients, decrease to normal or low levels (Danovitch GM 2005). The factors that might cause certain difficulties for the recovery of sexual and reproductive functions in this type of patients include prolonged use of peritoneal dialysis, high follicle stimulating hormone (FSH) serum levels before the transplant, and a deficient function of the graft (De Celis and Pedron-Nuevo 1999). A certain improvement has been reported as to semen quality in the three main parameters (number, morphology, and motility of the spermatozoa) in patients after kidney transplantation (De Celis and Pedron-Nuevo 1999).…”

“…The factors that might cause certain difficulties for the recovery of sexual and reproductive functions in this type of patients include prolonged use of peritoneal dialysis, high follicle stimulating hormone (FSH) serum levels before the transplant, and a deficient function of the graft (De Celis and Pedron-Nuevo 1999). A certain improvement has been reported as to semen quality in the three main parameters (number, morphology, and motility of the spermatozoa) in patients after kidney transplantation (De Celis and Pedron-Nuevo 1999). Several studies conducted to evaluate the effects of immunosuppressive regimens suggest that some of these agents are potentially gonadotoxic since they affect testicular function and decrease fertility.…”