Pre-treatment and post-treatment fertility in young male patients affected by Hodgkin and non-Hodgkin lymphoma.

OBJECTIVES: The aim of this study is to evaluate the fertility in young patients affected by Hodgkin and non-Hodgkin lymphoma, before and after chemotherapy and/or radiotherapy. We conducted a retrospective study to analyse how treatment affects male fertility and a perspective study to assess pre-treatment sperm quality. MATERIALS AND METHODS: 28 patients, treated in our center or referred to our Medically Assisted Procreation Center, from 2002 to 2011, were selected for the retrospective study and asked if interested in their fertility assessment. Semen samples were taken from 11 patients (mean age 31.55: range 20-45); other possible causes of impaired fertility were excluded. We analyzed pretreatment semen samples of 61 patients (mean age 29.08 +/- 9.5) affected by leukaemia or lymphoma that were selected for the perspective study and referred to the Sperm Bank of Pordenone. All semen samples were analysed accordingly to 1999 World Health Organization guidelines. RESULTS: In the retrospective study all semen samples of the 11 patients selected were altered. Six patients treated with high dose alkylating agents and abdominal/pelvic radiotherapy were found azoospermic, 3 with severe oligoasthenozoospermic, 1 oligoteratozoospermic and 1 asthenozoospermic. In the perspective study pretreatment semen quality was poor in most of the samples of the 61 patients selected. Normozoospermia was observed in 14% of patients affected by Hodgkin lymphoma and in 25% affected by non-Hodgkin lymphoma. CONCLUSION: Chemotherapy, radiotherapy or their combination are followed by a temporary but sometimes irreversible reduction of fertility potential. Pre-treatment semen quality is acceptable to proceed with cyopreservation techniques. Sperm cryopreservation should be offered to all post puberal male patients who have not yet conceived before treatment with gonado-toxic agents.