Prediction of posttreatment spermatogenesis in patients with testicular cancer by flow cytometric sperm chromatin structure assay

Abstract

The hypothesis to be tested was that abnormal sperm chromatin structure is related to disturbed spermatogenesis in patients with testicular cancer. After orchiectomy but before further treatment (“pretreatment”), semen samples from 39 patients with testicular cancer were analyzed for sperm concentration by light microscopy and by the sperm chromatin structure assay (SCSA). In 28 patients assessment of sperm concentration was repeated 12–26 months after orchiectomy (“posttreatment”). The pretreatment SCSA results for the patients were compared to those from 18 healthy semen donors and assessed for correlation with the patients' posttreatment sperm concentration. Twenty‐three patients displayed an abnormal chromatin structure in their pretreatment sample. For the nine evaluable patients on the surveillance program, the pretreatment SCSA results were not correlated with the posttreatment concentration. The results from 19 evaluable patients undergoing cytotoxic treatment (radiotherapy, 13; chemotherapy, 6) indicate that posttreatment recovery of spermatogenesis (recovery in 4 of 5 patients) is observed more often in patients with a normal pretreatment chromatin structure than in those with abnormal SCSA values before treatment (recovery in 2 of 14 patients; P = 0.02). The results of SCSA display sperm characteristics beyond those of light microscopically assessed sperm concentration. Pretreatment SCSA results might help clinicians to identify those testicular cancer patients with a high risk of long‐lasting posttreatment disturbance of spermatogenesis. Cytometry 30:192–196, 1997. © 1997 Wiley‐Liss, Inc.

Sperm DNA integrity in cancer patients: the effect of disease and treatment

“…These observations strengthen the conclusion that higher DFI% seen in cancer patients compared with controls is because of the cancer disease rather than to the procedure of cryopreservation or selection of controls. The slightly increased DFI% in HL and TGCC patients prior to chemo-or radiotherapy is in accordance with previous studies (Fossa et al, 1997;Gandini et al, 2000;O'Donovan, 2005;Spermon et al, 2006;O'Flaherty et al, 2008) but opposite to our own earlier results (Stahl et al, 2006). However, our previous results were based on a small group of TGCC patients.…”

Clinical correlates of the biological variation of sperm DNA fragmentation in infertile men attending an andrology outpatient clinic

“…Several studies have documented that conditions like abstinence time, fever, temperature alterations, seasonal changes, smoking, medication and exposure to environmental hazards can alter sperm DNA integrity (Fossa et al, 1997;Spano et al, 1998;Sanchez-Pena et al, 2004;Rignell-Hydbom et al, 2005); although, no association between sperm DNA fragmentation and the length of abstinence time was observed by De Jonge et al (2004). For our study, patients who reported changes in medication or any significant illness or infection between different semen samples were excluded.…”

Are Tests of Sperm DNA Damage Clinically Useful? Pros and Cons

“…Young men with cancer (eg, Hodgkin lymphoma and testicular cancer) typically have poor semen quality and sperm DNA damage even prior to cancer-specific therapy (O'Flaherty et al, 2008). They then experience cumulative dose damage during therapy (chemotherapy, radiation), often rendering them completely sterile (Fossa et al, 1997;Morris, 2002). The recovery of spermatogenesis may occur months to years after therapy, but evidence of sperm DNA damage may often persist beyond that period (Fossa et al, 1997).…”

“…They then experience cumulative dose damage during therapy (chemotherapy, radiation), often rendering them completely sterile (Fossa et al, 1997;Morris, 2002). The recovery of spermatogenesis may occur months to years after therapy, but evidence of sperm DNA damage may often persist beyond that period (Fossa et al, 1997). Patients who are scheduled to undergo definitive cancer therapy (surgery, chemotherapy, and/or radiation) are strongly encouraged to cryopreserve sperm for future use (Lee et al, 2006).…”