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Effects of cytotoxic agents on gonadal function in adult men

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

INTRODUCTION

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].

MECHANISM OF DRUG-INDUCED INFERTILITY

The mechanism of action of most cytotoxic chemotherapeutic agents is interference with obligatory cell processes, such as DNA synthesis, in the rapidly dividing cancer cells. However, all cells that undergo rapid division are susceptible to the toxic effects of chemotherapy.

                                

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Literature review current through: Nov 2016. | This topic last updated: Mon Nov 30 00:00:00 GMT+00:00 2015.
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