Men and SCT
- TBI
- The germinal epithelium is very sensitive to radiotherapy and doses as low as 0.3 Gy may result in decreased sperm counts and increased FSH levels. Leydig cell function, however, is usually spared and testosterone levels are normal. Following TBI for a standard allograft all patients become azoospermic.
- Chemical Conditioning
- Alkylating agents damage the germinal epithelium in the spermatogenesis but spare Leydig cells. The total dose of cyclophosphamide received and the length of time that the drug has been administered are important determinants of normal sperm recovery.
- After 200 mg/kg cyclophosphamide and SCT for aplastic anaemia, all men have normal testosterone levels. Semen analysis shows normal sperm motility and sperm count in about 2/3 of patients. The remainder show azoospermia.
Note: In view of the small but definite chance of regaining fertility after SCT and chemical conditioning, normal contraceptive methods should be recommended for such patients. Unwanted pregnancy in cancer patients can cause major problems. Discussion with patient and partner (if any) are of crucial importance.
Topic Code: 8764