ESPE Yearbook of Paediatric Endocrinology

To read the full abstract: PLoS One. 2019;14(12):e0226262. geraldine.delbes@iaf.inrs.ca

Male childhood cancer survivors (CCS) show reduced fertility, mostly due to low sperm count. The links between DNA damage caused by cancer and its treatment, pubertal stage at diagnosis and future infertility are still unclear. This Canadian pilot study analysed reproductive parameters and sperm characteristics in adult survivors of childhood leukaemia and lymphoma, divided into 2 groups according to whether cancer diagnosis occurred before or after puberty. They were compared to age-matched men with no history of cancer. No differences were observed in mean serum testosterone and FSH levels, but 4 CCS had FSH levels >8 U/ml. No differences in average sperm count or motility were observed across groups, but 5 of the 13 CCS were affected by azoo/oligozoospermia, regardless of the time at cancer diagnosis. Analysis of sperm chromatin and DNA integrity revealed no differences among the groups. The authors observed a significant negative correlation between sperm count and the cumulative dose of alkylating agent, determined by the cyclophosphamide equivalent dose, and a strong positive correlation between the cumulative dose of anthracyclines and the DNA fragmentation index. A limitation of the study is the small sample size, which makes it difficult to generalize the results. It is noteworthy that both groups of CCS had a similar prevalence of azoo/oligozoospermia, supporting the hypothesis that the prepubertal testis is not protected from damage in children who undergo cancer treatment.