Retrospective cohort study of pubertal testicular function in childhood cancer survivors and future fertility

Childhood cancer treatment can result in male infertility. Understanding which patients are at risk of future infertility would facilitate early fertility counseling. A cohort study at Helsinki Children’s Hospital (Finland) investigated associations between pubertal reproductive hormone levels and adult gonadal outcomes and cancer treatment exposures. In this study involving 221 male childhood cancer survivors, follicle-stimulating hormone (FSH) measurements during puberty among patients receiving testicular radiotherapy were associated with future azoospermia, with an optimal cutoff corresponding to 11.2 IU/L at age 14 years and 12.5 IU/L at age 16 years. For those receiving intermediate-dose alkyklating chemotherapy, increased FSH in puberty often resolved and Leydig cell function was maintained in adulthood. The authors conclude that these findings suggest that gonadotropin levels during puberty are associated with future testicular function among childhood cancer survivors.