Use of testosterone to prevent cyclophosphamide-induced azoospermia

Area of Science:

• Reproductive Endocrinology
• Oncology
• Nephrology

Background:

• Cyclophosphamide chemotherapy can cause germinal cell alterations in patients.
• Prepubertal patients show relative resistance to these effects.
• The protective role of testosterone in adult male fertility during chemotherapy requires investigation.

Purpose of the Study:

• To evaluate the potential protective effect of testosterone on germinal cell activity in men receiving cyclophosphamide.
• To assess testosterone's role in preserving fertility during cyclophosphamide treatment for nephrotic syndrome.

Main Methods:

• A randomized clinical trial was conducted at a university medical center.
• 15 male patients with nephrotic syndrome received 6–8 months of cyclophosphamide therapy.
• Interventions included oral cyclophosphamide, intravenous cyclophosphamide, or intravenous cyclophosphamide with concurrent testosterone administration.

Main Results:

• Patients receiving cyclophosphamide alone (n=10) became azoospermic, with limited recovery of sperm counts post-therapy.
• Elevated follicle-stimulating hormone (FSH) levels were observed in patients treated with cyclophosphamide alone.
• Patients receiving cyclophosphamide plus testosterone (n=5) experienced temporary azoospermia/oligospermia but achieved normal sperm counts and FSH levels 6 months after treatment cessation.

Conclusions:

• Testosterone administration prior to and during cyclophosphamide therapy may preserve fertility in adult males.
• This approach shows promise for mitigating chemotherapy-induced infertility in men with nephrotic syndrome.
• Further research is warranted to confirm these fertility-preserving effects.