Testicular Function After Immune-Checkpoint Inhibitors Treatment

Area of Science:

• Reproductive Endocrinology
• Oncology
• Immunology

Background:

• Immune-checkpoint inhibitors (ICIs) are increasingly used for melanoma treatment.
• Potential impacts of ICIs on male reproductive health, specifically spermatogenesis and testicular endocrine function, require investigation.

Purpose of the Study:

• To assess the effects of ICIs on sperm production and hormone levels in men with melanoma.
• To determine the prevalence and nature of testicular dysfunction associated with ICI therapy.

Main Methods:

• Prospective cohort study involving 26 men with melanoma undergoing ICI therapy.
• Semen analysis and serum hormone levels (FSH, LH, testosterone) were measured at baseline and post-treatment.
• Exclusion of patients with prior gonadotoxic therapies or radiotherapy.

Main Results:

• A modest, though not statistically significant, decline in sperm output and concentration was observed.
• One patient developed persistent azoospermia with elevated FSH, presumed autoimmune orchitis.
• Serum LH and testosterone remained stable; FSH elevation was primarily linked to the single autoimmune orchitis case.

Conclusions:

• ICI treatment may lead to minimal spermatogenic dysfunction and transient FSH increases, largely influenced by rare autoimmune orchitis.
• The unpredictable nature of these effects underscores the importance of fertility preservation counseling for young men initiating ICIs.