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Effects of cytotoxic agents on gonadal function in adult men

Frances J Hayes, MD
Glenn J Bubley, MD
Section Editors
Alvin M Matsumoto, MD
Reed E Drews, MD
Deputy Editor
Kathryn A Martin, MD


Significant advances have been made in the treatment of a number of malignancies in men. Increasing interest has therefore been focused on the late toxicities of cancer chemotherapy in long-term survivors. One of the most common long-term side effects of cytotoxic agents in men is gonadal dysfunction [1-4]. The following general rules apply to the gonadal toxicity of chemotherapy in the male.

Spermatogenesis is much more likely to be disrupted than is testosterone production, because the germinal epithelium of the testis is more sensitive to damage from cytotoxic drugs than the Leydig cells.

The degree of damage to the germinal epithelium is influenced by the stage of sexual maturation of the testis. In general, the postpubertal testis appears to be more susceptible to damage than the prepubertal testis [5].

The magnitude of the effect on sperm production is both drug specific and dose dependent [1,3,6-11].

The impact of cytotoxic agents on gonadal function in adult men is reviewed here. The impact of such agents on gonadal function and fertility in children, adolescents, and women is reviewed separately. (See "Endocrinopathies in cancer survivors and others exposed to cytotoxic therapies during childhood", section on 'Gonadal dysfunction' and "Ovarian failure due to anticancer drugs and radiation".)

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Literature review current through: Nov 2017. | This topic last updated: Nov 28, 2017.
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