Sperm aneuploidy after testicular cancer treatment: data from a prospective multicenter study performed within the French Centre d’Étude et de Conservation des Oeufs et du Sperme network

Bleomycin-etoposide-cisplatin (BEP) chemotherapy and radiotherapy may carry differential risks of heritable genetic defects in sperm nucleus, with the highest risk during the 6 months after the end of radiotherapy and the 12 months after chemotherapy with more than two BEP cycles.

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Volume 107, Issue 3, 580–588

Authors:

Nathalie Rives, M.D., Marie Walschaerts, Ph.D., Véronique Setif, Li.Sc., Sylvianne Hennebicq, M.D., Jacqueline Saias, M.D., Florence Brugnon, M.D., Jacques Auger, M.D., Isabelle Berthaut, Ph.D., Ethel Szerman, Ph.D., Myriam Daudin, M.D., Louis Bujan, M.D.

Abstract:

Objective

To study sperm aneuploidy in a population of testicular cancer (TC) patients treated with the use of either bleomycin-etoposide-cisplatin (BEP) chemotherapy or radiotherapy.

Design

Multicenter prospective longitudinal study of TC patients analyzed before treatment and after 3, 6, 12, and 24 months (T3–T24).

Patient(s)

Fifty-four TC patients and a control group of 10 fertile sperm donors.

Setting

University hospital laboratories.

Intervention(s)

Routine semen analyses; sperm aneuploidy and diploidy.

Main Outcome Measure(s)

Comparison of sperm characteristics and sperm chromosome abnormalities during TC patient follow-up.

Result(s)

Semen characteristics recovered pretreatment values 12 months after radiotherapy and 24 months after more than two BEP cycles. A significant increase in sperm disomy YY and XX was observed in the TC group before treatment compared with the control group. After more than two BEP cycles, the mean sperm aneuploidy rate increased significantly at T12 and reached the pretreatment value at T24. After radiotherapy, the mean sperm aneuploidy returned to the pretreatment value at T12. At T24, nearly 40% of TC patients did not recover their pretreatment sperm aneuploidy rate.

Conclusion(s)

Genetic counseling of TC patients should include information on the potential elevated risk of aneuploid conceptus from sperm recovered after treatment and the necessity to postpone conception up to ≥12 months after radiotherapy and ≥24 months after more than two BEP chemotherapy cycles. However, few men receiving one or two BEP cycles and some dropouts are the main limitations of this study.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

1 Comments

Go to the profile of T. Mike Hsieh
T. Mike Hsieh over 3 years ago

the result of this study adds to the importance of pre-treatment sperm cryopreservation in cancer patients. it's unclear the clinical significance of sperm aneuploidy since their fertilization potential is unknown. it will be interesting if these patients are followed long term to determine whether their sperm aneuploidy improves over time or at all.