GONADAL FUNCTION IN MALES TREATED WITH LIMITED CYCLOPHOSPHAMIDE FOR STEROID SENSITIVE NEPHROTIC SYNDROME

Abstract

Gonadal damage is known to occur following treatment with high dose and/or prolonged courses of cyclophosphamide (CP). However, the effect of limited treatment has not been well established. 53 boys with steroid sensitive nephrotic syndrome received a standardised 8 week course of 3mg/Kg body weight per day of CP at the Hospital for Sick Children, London, during 1966-1974. 23 boys now over the age of 18 years were recalled for assessment of gonadal function. 4 were known to have fathered children, 4 declined to participate in the study and 1 was untraceable. Mean age at the time of treatment was 10.7 years and mean interval to follow up 10.3 years. Semen analysis in 11 postpubertal males who received only one course of CP showed that sperm densities were lower than in controls of the same age (Patients 60 ± 9; Controls 103 ± 17; mean sperm densities ± S.E.; million/ml). Evidence of sperm dysfunction was observed in 8 of these patients, and also in 2 out of 3 patients who received 2 standardised courses of CP. Libido and sexual performance was assessed as normal in all but 2 patients in whom it was considered to be diminished. Antisperm antibodies were not detected in the sera of patients. The data suggest that gonadal dysfunction may occur in males who receive even limited treatment with CP.

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