Use of Testosterone To Prevent Cyclophosphamide-Induced Azoospermia

Masala A, Faedda R, Alagna S, et al. — Sat, 15 Feb 1997 00:00:00 GMT

Background:

Prepubertal patients receiving chemotherapy are relatively resistant to cyclophosphamide-induced germinal cell alterations.

Objective:

To study the possible protective effect of testosterone used to inhibit germinal cell activity in men who are receiving cyclophosphamide.

Design:

Randomized, clinical trial.

Setting:

University medical center.

Patients:

15 patients with the nephrotic syndrome who were treated with cyclophosphamide for 6 to 8 months.

Intervention:

Five patients received daily oral cyclophosphamide, five received cyclophosphamide in monthly bolus injections, and five received monthly intravenous boluses of cyclophosphamide plus testosterone (100 mg intramuscularly every 15 days).

Measurements:

Sperm counts, serum follicle-stimulating hormone levels, and serum luteinizing hormone levels were measured before, during, and after treatment with cyclophosphamide alone or cyclophosphamide plus testosterone.

Results:

The 10 patients who did not receive testosterone became azoospermic during cyclophosphamide therapy. In only 1 of the 10 patients did the sperm count return to normal 6 months after discontinuation of therapy. Follicle-stimulating hormone levels were elevated in these patients (mean ± SE, 19.20 ± 1.28 IU/L in patients receiving oral cyclophosphamide and 16.04 ± 2.22 IU/L in patients receiving intravenous cyclophosphamide alone). All 5 patients who received testosterone became azoospermic or severely oligospermic during treatment but had a normal sperm count 6 months after the discontinuation of therapy. In these patients, the mean sperm count was 45.78 ± 3.89 × 10^6/mL and follicle-stimulating hormone levels were normal (5.08 ± 0.56 IU/L).

Conclusion:

Testosterone given to men before and during an 8-month cycle of cyclophosphamide therapy for the nephrotic syndrome may preserve fertility.

Annals of Internal Medicine: Nephrotic Syndrome Topic Collection

Use of Testosterone To Prevent Cyclophosphamide-Induced Azoospermia