ABSTRACT
To investigate the effect of chemotherapy on gonadal function of young men cured of childhood Hodgkin's disease. Young adult males surviving Hodgkin's disease, aged 17 and over at least 2 years after therapy were studied in Ali Asghar Children's Hospital, Tehran, Iran from March 2000 to March 2005. Clinical evaluation for secondary sexual characteristics, semen analysis, follicle stimulating hormone [FSH], luteinizing hormone [LH], and testosterone was studied in 33 survivors of Hodgkin's disease. The age at diagnosis was 5-15 years, median 9 years, age at study 17-29 years, median 19 years old. The median duration off therapy was 7 years [2-20 years]. All 33 patients received chemotherapy as follows: 32 patients received nitrogen mustard [mechlorethamine], vincristine [Oncovin], procarbazine, prednisone [MOPP] / doxorubicin [adriamycin], bleomycin, vinblastine, dacarbazine [ABVD] 6-8 cycles, 5 of whom after relapses received other protocols. One received only MOPP. Twenty-seven [81.8%] had azoospermia, 2 had severe oligospermia, 3 had oligospermia, and one had normal sperm count [58000,000]. All patients had normal secondary sexual characteristic. The FSH, and LH in 6/33 patients were above normal. Testosterone in 3/33 was below normal. A prepubertal status does not protect the gonads from the harmful effect of chemotherapy, and approximately 87% of male survivors of Hodgkin's disease develop azoospermia or severe oligospermia