One course of adjuvant chemotherapy has minimal impact on sperm count in men with early stage testicular cancer, a Swedish study has shown.

In the study, 182 men diagnosed with stage I testicular cancer and who had had an orchiectomy within the past five years received radiotherapy (14 fractions of 1.8 Gy each, up to a total dose of 25 Gy) or one cycle of chemotherapy (BEP: bleomycin, etoposide, cisplatin, 5 day regimen), or adjuvant carboplatin, or surveillance.

During 60 months of follow up, no significant differences in total sperm number (TSN) and sperm concentration (SC) were seen between treatment groups except for a transient decrease in the radiotherapy group in the first six months. Sperm counts were rather stable over time in all groups, according to the results published in Annals of Oncology.

Study lead author Dr Kristina Weibring, an oncologist at the Karolinska University Hospital in Stockholm, said it was known that several rounds of chemotherapy or high doses of radiotherapy given to men with more advanced testicular cancer can reduce sperm count and concentration. But it has been unclear whether a single cycle of chemotherapy or radiotherapy would have a similar effect in men with stage I disease.

“I am very excited to see these results as I wasn’t expecting sperm to recover so well after postoperative treatment. I didn’t expect as negative an effect as if the patient had received many courses of chemotherapy, since it is much more toxic, but I was not sure how much the sperm would be affected by one course,” she said.

“With the results of this study we can give the patients more adequate information on potential side effects from postoperative treatment. Testicular cancer patients are often young men wanting to father children at some point, and we find, in many cases, that the patients are afraid of the potential risk of infertility caused by chemotherapeutic treatment. These findings should provide some reassurance to them.”

However Dr Weibring added that: further confirmatory studies were needed and also studies looking at he effects of different chemotherapy regimens.

“And we still recommend sperm banking before orchiectomy as a number of patients may have low sperm counts at the time of diagnosis that persists after postoperative treatment. In addition, the type of testicular cancer and whether or not it will need further treatments are unknown factors before the orchiectomy. Assisted reproductive measures may be necessary for these patients regardless of any treatment given.”