Rapid recovery of spermatogenesis after mitoxantrone, vincristine, vinblastine, and prednisone chemotherapy for Hodgkin's disease.

1997 ◽  
Vol 15 (12) ◽  
pp. 3488-3495 ◽  
Author(s):  
M L Meistrich ◽  
G Wilson ◽  
K Mathur ◽  
L M Fuller ◽  
M A Rodriguez ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Male Fertility ◽  
Sperm Count ◽  
Hodgkin’S Disease ◽  
Spermatogenic Cells ◽  
Sperm Production ◽  
Human Male ◽  
Sperm Counts ◽  
Abdominal Radiotherapy ◽  
Upper Abdominal

PURPOSE Because the effects of mitoxantrone on human male fertility were unknown, we determined prospectively the effects of three courses of mitoxantrone (Novantrone), vincristine (Oncovin), vinblastine, prednisone (NOVP) chemotherapy on the potential for fertility of men with Hodgkin's disease (HD). PATIENTS AND METHODS Semen analyses were performed on 58 patients with stages I-III HD before, during, and after chemotherapy and after the sperm count recovered from the effects of abdominal radiotherapy that was given after chemotherapy. RESULTS Before the initiation of treatment, 84% of the patients were normospermic. Sperm counts declined significantly within 1 month after the start of NOVP chemotherapy. In the month after chemotherapy, 38% of patients were azoospermic, 52% had counts < 1 million/ mL, and 10% had counts between 1 and 3 million/mL. Between 2.6 and 4.5 months after the completion of chemotherapy, sperm counts recovered rapidly to normospermic levels in 63% of patients. In the remaining patients who were followed up for at least 1 year after standard upper abdominal radiotherapy, counts also recovered to normospermic levels. CONCLUSION NOVP chemotherapy, like most other regimens, produced marked temporary effects or spermatogenesis. However, sperm production recovered very rapidly, within 3 to 4 months after the end of NOVP chemotherapy. This pattern was caused by killing differentiating spermatogenic cells, but there was little cytotoxicity or inhibition of stem cells from mitoxantrone or the other drugs. After the combination of NOVP plus abdominal radiotherapy, sperm counts and motility were restored in most patients to pretreatment levels, which were compatible with normal fertility.

Recovery of spermatogenesis after treatment for Hodgkin's disease: limiting dose of MOPP chemotherapy.

1984 ◽  
Vol 2 (6) ◽  
pp. 571-577 ◽  
Author(s):  
M F da Cunha ◽  
M L Meistrich ◽  
L M Fuller ◽  
J H Cundiff ◽  
F B Hagemeister ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Sperm Production ◽  
Pelvic Irradiation ◽  
Recovery Rates ◽  
Sperm Counts ◽  
Radiotherapy Treatment ◽  
Maximum Exposure

The sperm production of 25 patients with Hodgkin's disease treated with mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) chemotherapy was studied retrospectively. All but two patients also received radiotherapy treatment to pelvic and/or non-pelvic fields. Sperm counts were obtained from patients treated either with three or fewer (MOPP-2 group) or with five or more (MOPP-6 group) chemotherapy cycles. Recovery of spermatogenesis following treatment-induced azoospermia was significantly higher among the MOPP-2 patients (Mann-Whitney rank sum test, p = 0.001). Patients in this group who did not receive pelvic irradiation appeared to have greater recovery rates (p = 0.06). The results suggest that three cycles of MOPP chemotherapy represent a maximum exposure compatible with the recovery of spermatogenesis.

scholarly journals Environmental and Nutritional Aspect in Male Infertility

1970 ◽  
Vol 10 (1) ◽  
pp. 16-19 ◽  
Author(s):  
Hamida Begum ◽  
ABM Moniruddin ◽  
Khairun Nahar
Keyword(s):  
Heavy Metals ◽  
Male Infertility ◽  
Sperm Count ◽  
Sperm Production ◽  
Male And Female ◽  
Exogenous Estrogen ◽  
Sperm Counts ◽  
And Function ◽  
Nutritional Aspect ◽  
Anatomical Defects

Male and female partner of a couple must be standard and fit to have the capacity to procreate. Studies confirm that male sperm counts are declining and environmental factors as pesticides, exogenous estrogen, heavy metals negatively impact spermatogenesis without any obvious anatomical defects. So, a number of nutritional therapies have been shown to improve sperm count and motility as carnitine, arginine, zinc, selenium and vitamin B12. Numerous anitioxidants have prove beneficial in treating male infertility as Vitamin C, Vitamin E, Glutathione and Coenzyme Q10. This article aims to highlight the correction of nutritional imbalances to encourage optimum sperm production and function, when there is idiopathic impaired spermatogenesis.   doi:10.3329/jom.v10i1.1997   J Medicine 2009; 10: 16-19   

Evaluation of the efficacy of the VEEP regimen in adult Hodgkin's disease with assessment of gonadal and cardiac toxicity.

1995 ◽  
Vol 13 (2) ◽  
pp. 387-395 ◽  
Author(s):  
M Hill ◽  
S Milan ◽  
D Cunningham ◽  
J Mansi ◽  
I Smith ◽  
...  
Keyword(s):  
Acute Toxicity ◽  
Hodgkin's Disease ◽  
Sperm Count ◽  
Hodgkin’S Disease ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Second Malignancies ◽  
Bulky Disease ◽  
Ventricular Ejection Fraction

PURPOSE The aim of this phase II study was to investigate the potential of the vincristine, epirubicin, etoposide, and prednisolone (VEEP) regimen to reduce the risks of long-term sequelae of chemotherapy such as sterility, cardiopulmonary damage, and second malignancies, while maintaining efficacy in terms of response and survival. PATIENTS AND METHODS Eighty-five adult patients with newly diagnosed and previously untreated stage II to IV Hodgkin's disease (HD) were entered and monitored for a minimum of 1 year. Patients were treated to maximum response plus two further courses, and if they had not attained a complete response (CR) or CR-unconfirmed/uncertain [CR(u)] were changed to second-line chemotherapy. Adjuvant radiotherapy was administered to patients with bulky disease and those with postchemotherapy residual masses. Measurements of left ventricular ejection fraction (LVEF), gonadotropins in females, and sperm count in males were taken both before and after treatment with VEEP. RESULTS The maximum rates of response were as follows: CR, 32%; CR(u), 47%; and PR, 21% [CR + CR(u), 79%]. The median follow-up duration is 45 months, with a 5-year overall survival (OS) rate of 89% and failure-free survival (FFS) rate of 62%. Patients in CR at the end of chemotherapy had a higher FFS at 5 years compared with patients in CR(u) (88% v 56%). Acute toxicity was mild, with no pulmonary toxicity or treatment-related deaths. The median LVEF was 62% before VEEP and 57% after VEEP. Gonadal function tests following treatment were normal in 92% of males and 100% of females. No second malignancies have been observed. CONCLUSION VEEP is an active combination with tolerable acute toxicity that preserves fertility and cardiopulmonary function. The efficacy of VEEP is comparable to that of established regimens, but a definitive evaluation of its potential to reduce second malignancies will require a longer follow-up duration.

Gonadal function following chemotherapy for Hodgkin's disease: a comparative study of MVPP and a seven-drug hybrid regimen.

1995 ◽  
Vol 13 (1) ◽  
pp. 134-139 ◽  
Author(s):  
S T Clark ◽  
J A Radford ◽  
D Crowther ◽  
R Swindell ◽  
S M Shalet
Keyword(s):  
Hodgkin's Disease ◽  
Sperm Count ◽  
Hodgkin’S Disease ◽  
Semen Analysis ◽  
Hormone Replacement ◽  
Ovarian Failure ◽  
Gonadal Function ◽  
Early Menopause ◽  
Gonadal Dysfunction ◽  
Significant Difference

PURPOSE AND METHODS Gonadal function was assessed in 89 patients after chemotherapy for Hodgkin's disease (HD). Thirty-seven patients had received mechlorethamine, vinblastine, prednisolone, and procarbazine (MVPP) and 52 patients, a hybrid combination of chlorambucil, vinblastine, prednisolone, procarbazine, doxorubicin, vincristine, and etoposide (ChIVPP/EVA). Fifty men (MVPP, n = 21; ChIVPP/EVA, n = 29) with a median age of 26 years (range, 16 to 54) and 39 women (MVPP, n = 16; ChIVPP/EVA, n = 23) with a median age of 30 years (range, 15 to 47) were studied at a median of 30 months (range, 4 to 83) following chemotherapy. RESULTS Semen analysis showed azoospermia in 35 of 37 men, and increased serum follicle-stimulating hormone (FSH) levels in this group confirmed severe germinal epithelial damage. Analysis of pretreatment semen in 28 men showed azoospermia in one, oligospermia in four (sperm count < 20 x 10(6)/mL), and a normal sperm count in the remaining 23. In the women, 26 of 34 (76%) with a regular menstrual cycle before commencing chemotherapy became amenorrheic following treatment. Menses returned in 10 women, who had a median age of 25 years (range, 21 to 34), and there were two pregnancies in this group. In the other 16, with a median age of 36 years (range, 27 to 47), amenorrhea persisted and premature ovarian failure was confirmed by increased serum gonadotrophins and reduced estradiol (E2) concentrations. Of the original eight women in whom menses were maintained following treatment, two subsequently developed amenorrhea and the clinical and biochemical features of an early menopause. In total, 18 of 34 women (53%) required hormone replacement therapy for chemotherapy-induced ovarian failure. CONCLUSION There was no statistically significant difference in the frequency or severity of gonadal dysfunction between MVPP- and ChIVPP/EVA-treated patients. We conclude that both of these chemotherapy schedules cause substantial damage to gonadal function in both sexes.

scholarly journals Torpor expression is associated with differential spermatogenesis in hibernating eastern chipmunks

2020 ◽  
Vol 319 (4) ◽  
pp. R455-R465
Author(s):  
Marianne F. Gagnon ◽  
Christine Lafleur ◽  
Manuelle Landry-Cuerrier ◽  
Murray M. Humphries ◽  
Sarah Kimmins
Keyword(s):  
Dna Damage ◽  
Spermatogenic Cells ◽  
Sperm Production ◽  
Physiological Processes ◽  
Data Loggers ◽  
Sperm Counts ◽  
Low Levels ◽  
Potential Impact ◽  
Eastern Chipmunks ◽  
The Relationship

Hibernators suppress physiological processes when expressing torpor, yet little is known about the effects of torpor on male reproductive physiology. Studies of hibernating mammals suggest that deep torpor negatively impacts spermatogenesis and that transitions between torpor and euthermic arousals increase cellular oxidative stress, with potentially damaging effects on sperm. Here, we hypothesize that variation in torpor expression affects the reproductive readiness of hibernators by impacting their sperm production. To test this, we examined the relationship between torpor expression and spermatogenesis in captive eastern chipmunks ( Tamias striatus). We determined torpor depth with temperature data loggers and assessed its relationship with spermatogenesis by examining spermatogenic progression, cell division, sperm counts, sperm maturity, and DNA damage. We show that deep hibernators (high levels of torpor) largely halted spermatogenesis in late hibernation in comparison with shallow hibernators (low levels of torpor), where ongoing spermatogenesis was observed. Despite these differences in spermatogenic state during hibernation, spermatogenic progression, sperm numbers, and maturity did not differ in spring, potentially reflecting similar degrees of reproductive readiness. Interestingly, shallow hibernators exhibited higher rates of DNA damage in spermatogenic cells during hibernation, with this trend reversing in spring. Our results thus indicate that once heterothermy is terminated, deep hibernators resume spermatogenesis but are characterized by higher rates of DNA damage in spermatogenic cells at the seasonal stage when spring mating commences. Therefore, our study confirmed posthibernation recovery of sperm production but also a potential impact of deep torpor expression during winter on DNA damage in spring.

Use of total abdominal or upper abdominal irradiation in the management of Hodgkin's disease

1977 ◽  
Vol 2 ◽  
pp. 54-55
Author(s):  
Shalom Kalnicki ◽  
Leonard Kessler ◽  
Lemuel Ariaratnam ◽  
Flora Mincer ◽  
Anastasios Katsenis ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Upper Abdominal ◽  
Abdominal Irradiation

Pregnancy outcome in patients treated for Hodgkin's disease.

1993 ◽  
Vol 11 (3) ◽  
pp. 507-512 ◽  
Author(s):  
J Aisner ◽  
P H Wiernik ◽  
P Pearl
Keyword(s):  
General Population ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Reproductive Age ◽  
Combined Modality Treatment ◽  
Spontaneous Abortions ◽  
Sperm Counts ◽  
Study Population ◽  
Male Patients ◽  
Living Children

PURPOSE This study attempted to determine the outcome of pregnancies in patients (or their partners) who were successfully treated for Hodgkin's disease and to assess the effect of treatment on the children of the treated parents. MATERIALS AND METHODS A questionnaire was distributed to and personal interviews were conducted with patients who were of reproductive age at the time of treatment with consecutive protocols of radiotherapy, chemotherapy, or both. Those premenopausal patients (or the sexual partners of patients) who attempted to conceive after successful treatment constituted the study population. Fertility assessment was based only on those patients identified as desiring children. RESULTS Among 391 adult patients, 221 patients (104 females and 117 males) of reproductive age were interviewed. Before treatment, 63 of the 221 patients had 135 pregnancies, which resulted in 118 children, 11 spontaneous abortions, five elective abortions, and one stillborn. After treatment, 94 patients (43 females and 51 males) actively attempted conception; 35 females and 25 partners of male patients had 84 pregnancies, which resulted in 68 living children. Among the 84 pregnancies, there were one premature birth at 29 weeks, three spontaneous abortions, 11 elective abortions, and two stillborn: one at 32 weeks and one set of twins. The children have been observed for a median of 11 years (minimum follow up > 4.5 years). Of those patients who desired children, 35 of 43 females became pregnant, whereas only 25 of the 51 partners of male patients became pregnant. At least five male patients with low sperm counts apparently fathered children. CONCLUSIONS This study demonstrates that both men and women have the potential for fertility after treatment regardless of treatment modality. The partners of male patients who were treated with combined modality treatment had a lower frequency of pregnancy than did the female patients who attempted conception and their frequency of pregnancy was also lower than the general population. There was no apparent increase in complications of pregnancy, spontaneous abortions, or congenital abnormalities after treatment compared with pregnancies in this patient group before treatment or with pregnancies in the general population.

Suppression of spermatogenesis by exogenous testosterone

2020 ◽  
Vol 26 ◽  
Author(s):  
Ferdinando Fusco ◽  
Paolo Verze ◽  
Marco Capece ◽  
Luigi Napolitano
Keyword(s):  
Male Fertility ◽  
Leydig Cells ◽  
Sperm Count ◽  
Sperm Concentration ◽  
Seminiferous Tubules ◽  
Sperm Production ◽  
Long Term Effects ◽  
Fertility Status ◽  
Normal Spermatogenesis

: Sperm production starts from puberty in the seminiferous tubules providing for testosterone production by the Leydig cells taking place in the interstice of the testicles. Normal spermatogenesis depends on specific signalling from the hypothalamic-pituitary-gonadal axis. GnRH, FSH and LH are the main hormones involved in the production and maturation of spermatozoa. Exogenous administration of androgens influences the hypothalamic-pituitary-gonadal axis with negative feedback that may lead to partial or complete cessation of spermatogenesis by decreasing FSH and LH. Despite the fact that many trials have confirmed that exogenous testosterone affects male fertility status, evidence regarding the long-term effects of treatment is conflicting. Regarding this aspect, many studies have confirmed a return to baseline sperm concentration after testosterone treatment discontinuation, however none of them can specify how long recovery will take nor whether the sperm count is sufficient for fertility.

Clinical trial with levo-norgestrel and testosterone oenanthate for male fertility control

1980 ◽  
Vol 95 (2) ◽  
pp. 251-257 ◽  
Author(s):  
Marie Føgh ◽  
Charles S. Corker ◽  
Helen McLean ◽  
William M. Hunter ◽  
Ivan Bruunshuus Petersen ◽  
...  
Keyword(s):  
Side Effects ◽  
Male Fertility ◽  
Sperm Morphology ◽  
Sperm Count ◽  
Recovery Period ◽  
Fertility Control ◽  
Recovery Phase ◽  
High Dose ◽  
Low Doses ◽  
Sperm Counts

Abstract. Two groups of six men took levo-norgestrel (250 or 500 μg daily) by mouth and testosterone oenanthate (200 mg monthly, intramuscurlarly) for six months. A three months placebo period preceded the medication which was followed by a recovery phase of 6–10 months. Two volunteers withdrew due to side effects. The five men taking the low doses of levo-norgestrel (250 μg) exhibited a reduction in sperm count, but not to azoospermia. The high dose of levo-norgestrel (500 μg) was more effective, sperm count was reduced to < 6 × 106/ ml in 3 of 5 volunteers and to < 17 × 106/ml in the remainder. s-Testosterone, LH and FSH were decreased by the treatment. The men had no toxicological side effects or changes in libido and potency. During the recovery period sperm counts, sperm morphology, s-testosterone, LH and FSH returned to normal levels.

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