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. 2023 Feb 13;29(4):486–517. doi: 10.1093/humupd/dmad002

Table III.

Semen analysis in childhood or adolescent males diagnosed with Hodgkin lymphoma.

Study N patients Age at diagnosis (years) Age at time of study (years) Follow-up (years) Treatment Outcome
Pre-treatment
Adam et al., 2020 24 17.2 ± 1.7 NA NA NA

  • Volume 2.0 ± 1.3, concentration 39.7 ± 37.0, sperm count 97 ± 103

    progressive motility 39.8 ± 24.7, total motile sperm count 19.9 ± 24.5

    azoospermic patients were excluded (number n.s.)

    There was a trend towards fewer straws among HL patients, when compared to other cancer diagnoses, P = 0.051
Bahadur et al., 2002 36 16.44 NA NA NA

  • Volume 1.4 (SEM0.2), sperm count 55.6 (SEM7.3)

  • overall motility (%abc) 51.7 (SEM 2.8)
DiNofia et al., 2017 54 16.9 ± 2.6 NA NA NA n = 8/54 (15%) azoospermia
Ginsberg et al., 2008 13 16.1 ± 0.5 NA NA NA n = 0/13 (0%) azoospermia. n = 5/13 (39%) oligospermia
Hagenäs et al., 2010 19 16.4 (12.7–17.9) NA NA NA

  • Volume 1.7 (0.1–5.9), concentration 8.5 (0–86), sperm count 7 (0–243),

  • progressive motility 35% (0–86%), total motile sperm 3.2 (0–186)

  • n = 1/19 (5%) azoospermia, n = 13/19 (68%) oligospermia
Heikens et al., 1996 19 11.0 (5–15) NA NA NA Sperm count 3.4 ± 5.5
Keene et al., 2012 38 16.2 ± 1.2 NA NA NA

  • Volume 0.5 (0.4–1.1), concentration 15.0 (1–56)

  • progressive motility 20% (13–29%)
Krawczuk-Rybak et al., 2012 10 15–18 NA NA NA

  • Sperm count range 30–175, progressive motility 10–45%

  • n = 0/4 (0%) azoospermia, n = 3/4 (75%) theratospermia, n = 4/4 (100%) asthenozoospermia.
Laddaga et al., 2022 11 (17–24) NA NA NA n = 8/11 (73%) with dyspermia (6× oligospermia, 5× azoospermia, 1× theratospermia).
Menon et al., 2009 30 17.8 ± 0.1 (13–20) NA NA NA

  • Volume 2.3 ± 0.2, sperm count 29.9 ± 5.7

  • progressive motility 29.3 ± 2.5%

  • n = 4/8 (50%) azoospermia
Paoli et al., 2016 50 15.8 ± 1.1 NA NA NA

  • Volume 1.8 ± 1.3, concentration 63.7 ± 69.9, sperm count 96.8 ± 94.7

  • progressive motility 39.6 ± 15.3%

  • Azoospermic patients were excluded (number n.s.)
van Casteren et al., 2008 20 16.3 (SEM 0.3) NA NA NA

  • Volume 0.8 (0.2), concentration 12.0 (SEM 5.1)

  • motility 29.5% (SEM 3.9)
Post-treatment
Anselmo et al. 1990 20 20 (16–24) n.s. (0.5–1)

  • Chemo: MOPP, ABVD, MOPP/ABVD

  • Pelvic RT: n.s.

  • n = 16/20 (80%) azoospermia

  • n = 2/20 (10%) oligospermia.

  • n = 3 azoospermatic patients (treated with 6 cycles of MOPP) and n = 2 oligospermatic patients (treated with 6 cycles of ABVD) had late recovery at 30, 57, 108, 18, and 19 months post-treatment, respectively
Aubier et al., 1989 10 10 (8–15) n.s. 9 (1–20)

  • Chemo: MOPP, VELBE, ABVD

  • No pelvic RT

 n = 7/10 (70%) azoospermia
Ben Arush et al., 2000 12 13.7 (2.1–16.4) 22 (14.8–29.3) 9.8 (4–19)

  • Chemo: MOPP, ABVD

  • Pelvic RT: n = 4/201 (20%), 1650–4000 rad1

  • n = 7/12 (58%) azoospermia.

  • n = 4/12 (33%) oligospermia
Bordallo et al., 2004 21 10 (6–19) 18 (17–23) (3–11)

  • Chemo: C-MOPP, ABV

  • No pelvic RT

  • n = 11/18 (61%) azoospermia

  • n = 4/18 (22%) oligospermia
Brämswig et al., 1990 75 12.44 ± 2.1 17.24 ± 2.19 4.3 ± 1.9

  • Chemo: OPPA, COPP

  • Pelvic RT: n = 10/75 (13%), 18–40 Gy

 n = 4/4 (100%) azoospermia in patients with elevated FSH
da Cunha et al., 1984 12 20 (15–24) n.s. 4 (1.2–10.6)

  • Chemo: MOPP

  • Pelvic RT: n = 4/12 (33%), 150–425 rad

  • n = 5/12 (42%) azoospermia

  • n = 3/12 (25%) oligospermia

  • n = 2 azoospermic patients became oligospermic at 14 and 127 months post-treatment. n = 2 oligospermic patients recovered to sperm counts within normal range at 41 and 103 months post-treatment. All patients were treated with no more than 3 MOPP courses, 1 had received pelvic irradiation.
Dhabhar et al., 1993 26 12 (4–15) 17 (15–23) 6.1 (2.3–11)

  • Chemo: COPP, ABVD, MOPP

  • No pelvic RT

 n = 18/18 (100%) azoospermia
Donaldson et al., 2007 75 13.3 (3.6–21) n.s. 9.6 (1.7–15.0)

  • Chemo: VAMP.

  • Pelvic RT: n.s.

 n = 1/1 (100%) azoospermia
Gözdasoglu et al., 1995 10 n.s. 18 (11–29) (5–24)

  • Chemo: C-MOPP

  • Pelvic RT: n.s.

 n = 4/4 (100%) azoospermia in patients with elevated FSH
Green and Hall, 1988 48 14.9 (5.1–19.9) (18.1–42.3) n.s.

  • Chemo: n.s.

  • Pelvic RT: n = 18/48 (38%)

 n = 8/8 (100%) azoospermia
Heikens et al., 1996 19 11.0 (5–15) 19 (16–27) 14 (13–20)

  • Chemo: MOPP

  • Pelvic RT: n = 2/19 (11%), 20–25 Gy

  • n = 12/19 (63%) azoospermia

  • n = 6/19 (32%) oligospermia

  • No recovery of spermatogenesis up to 20 years after treatment (n = 19 patients, treated with 6 cycles of MOPP, 2 received pelvic irradiation).
Hobbie et al., 2005 11 13.2 (6–19) 21 (18–31) 6.5 (1.5–21)

  • Chemo: COPP-ABV

  • No pelvic RT

  • n = 7/11 (64%) azoospermia.

  • n = 2/11 (18%) oligospermia
Jaffe et al., 1988 13 11 (6–15) 22 (20–27) 12 (5–15)

  • Chemo: COPP, MOPP

  • Pelvic RT: n = 13/13 (100%), 37–399 rad

  • n = 9/12 (75%) azoospermia.

  • n = 2/12 (17%) oligospermia
Koziner et al., 1986 11 21 (9–29) n.s. 3 (0.8–2.4)

  • Chemo: MOPP.

  • Pelvic RT: n.s.

 n = 8/11 (73%) azoospermia
Kruseová et al., 2021 81 13.7 (0.1–19.1) 23.6 (14.9–40.3) 11.6 (5.1–32)

  • Chemo: n.s.

  • Pelvic RT: n = 26/1431 (18%), 24.8 (15–40) Gy1

 n = 60/81 (74%) with spermatogenesis damage (i.e. azoospermia, oligozoospermia or asthenozoospermia)
Laddaga et al., 2022 11 (17–24) n.s. 8.6 (4.4–14)

  • Chemo: ABVD

  • No pelvic RT

 n = 4/11 (36%) with dyspermia (i.e. n = 3 oligospermia, n = 4 azoospermia, n = 1 theratospermia)
Mackie et al., 1996 46 12.2 (8.2–15.3) n.s. 6 (2.5–11.1)*

  • Chemo: ChlVPP

  • No Pelvic RT

 n = 7/7 (100%) azoospermia
Müller et al., 1996 13 14 (3–17) 21 (19–34) 8 (1–18)

  • Chemo: CPP

  • Pelvic RT: n = n.s., 2–50 cGy

 n = 6/6 (100%) azoospermia.
Ortin et al., 1990 20 13 (12–15) n.s. 9 (up to 26)

  • Chemo: MOPP, PAVe, ABVD, VBM

  • Pelvic RT: n = 12/20 (60%), 20–44 Gy

  • n = 11/19 (59%) azoospermia

  • n = 3/19 (16%) oligospermia

  • 2 boys had late recovery (one had normal sperm counts, 12 years post-treatment, one was azoospermic up to 10 years post-treatment, but successfully fathered a child 12 years after treatment). The semen analysis of the remaining 10 boys (with azoospermia showed no recovery during follow-up (up to 14 years after treatment)). All boys were treated with 6 cycles of MOPP, 4 were irradiated in the pelvic area.
Papadakis et al., 1999 36 13.0 (2.4–22.6) 22.3 (15.1–32.5) 6.8 (2.0–19.3)*

  • Chemo: MDP

  • Pelvic RT: n = 6/36 (17%)

 n = 2/2 (100%) azoospermia
Perrone et al., 1989 7 9.0 (2.4–12.0) 10.8 (3.0–18.0) 1.2 (0.2–6.5)

  • Chemo: ABVD, MOPP

  • Pelvic RT: n = 2/7 (29%), 2500 rad

 n = 3/3 (100%) azoospermia
Rafsanjani et al., 2007 33 9 (5–15) 19 (17–29) 7 (2–20)*

  • Chemo: MOPP, ABVD

  • No pelvic RT

  • n = 27/33 (82%) azoospermia

  • n = 2/33 (6%) oligospermia
Relander et al., 2000 11 13 (6–16) n.s. 11.4 (6.3–22.2)

  • Chemo: MOPP, MVPP, ABVD

  • Pelvic RT: at least n = 5/11 (45%), 40 Gy

  • n = 3/9 (33%) azoospermia

  • n = 0/9 (0%) oligospermia
Romerius et al., 2010 19 10 (0.1–17) 29 (20–46) >4*

  • Chemo: n.s.

  • Pelvic RT: n.s.

 n = 10/19 (53%) azoospermia
Shafford et al., 1993 40 n.s. >16 >6*

  • Chemo: ChlVPP, MOPP, MVPP, COPP, ABVD, PAVE, CCNU

  • Pelvic RT: n = 10/40 (25%), 2250–3500 cGy

  • n = 11/13 (85%) azoospermia,

  • n = 1/13 (8%) oligospermia
van Beek et al., 2007a 56 11.4 (3.7–15.9) 27.0 (17.7–42.6) 15.5 (5.6–30.2)

  • Chemo: ABVD, EBVD, MOPP

  • No pelvic RT

  • n = 9/21 (43%) azoospermia

  • n = 4/21 (19%) oligospermia

  • n = 9/17 (53%) azoospermia, n = 4/17(24%) oligospermia MOPP+ patients.

  • n = 0/4 (0%) azoospermia/oligospermia in MOPP-

    Mean sperm concentration 49.1 (26–63) MOPP− (n = 4), and 1.1 (0–72) MOPP+ (n = 17)
van Casteren et al., 2008 20 16.3 (SEM 0.3) n.s. 3.4 (0.8–14.0)

  • Chemo: n.s.

  • Pelvic RT: n.s.

 n = 2/4 (50%) azoospermia.
van den Berg et al., 2004 33 11.8 (3.8–17.2) n.s. 11.3 (0.5–24)

  • Chemo: MOPP, ABVD

  • Pelvic RT: n.s.

  • n = 9/13 (69%) azoospermia

  • n = 1/13 (8%) oligospermia

  • n = 8/10 (80%) azoospermia, n = 1/10 (10%) oligospermia in MOPP-group.

  • n = 0/1 (0%) azoospermia in ABVD group

  • n = 1/2 (50%) azoospermia in ABVD-MOPP group

Whitehead et al., 1982 15 11.2 (4.8–14.8) n.s. 3.3 (0,7–8)*

  • Chemo: MOPP, MVPP, ABVD.

  • Pelvic RT: n = 5/17 (29%), 100–300 cGy dose received by testes

 n = 6/6 (100%) azoospermia
Zaletel et al., 2010 40 13 (3–16) 21 (13–34) 10 (4–27)

  • Chemo: MOPP, LOPP, ABV(D), COPP(A), OPPA

  • Pelvic RT: n = 11/40 (28%), 30 (22–45) Gy

 n = 6/6 (100%) azoospermia in males with primary hypogonadism (defined as basal serum FSH and/or LH level above the normal upper limit and exaggerated response after the administration of LH-RH. Gonadotropin releasing hormone)
*

Follow-up period defined as years off treatment.

1

Reported number only available within total cohort (i.e. not specified for HL diagnosis or age-subgroup).

ABV, Adriamycin (Doxorubicin), Bleomycin, Vinblastine; ABVD, Adriamycin (Doxorubicin), Bleomycin, Vinblastine, Dacarbazine; CCNU, Chlorambucil, Etoposide; Chemo, chemotherapy; CHlVPP, Chlorambucil, Vinblastine, Procarbazine, Prednisone; C-MOPP, Cyclophosphamide, Nitrogen mustard, Vincristine (Oncovin), Procarbazine, Prednisone; COPP, Cyclophosphamide, Vincristine (Oncovin), Procarbazine, Prednisone; CPP, Cetuximab, Paclitaxel, Cisplatin; EBVD, Epirubicin, Bleomycin, Vinblastine, Dacarbazine; Gy, gray; LOPP, Chlorambucil, Vincristine (Oncovin), Procarbazine, Prednisone; MDP, Adriamycin (Doxorubicin), Procarbazine, Prednisone, Vincristine (Oncovin), Cyclophosphamide; MOPP, Mechlorethamine, Vincristine (Oncovin), Procarbazine, Prednisone; MVPP, Mechlorethamine, Vinblastine, Procarbazine, Prednisone; NA, not applicable; n.s., not specified; N, number; OPPA, Vincristine (Oncovin), Prednisone, Procarbazine, Adriamycin (Doxorubicin); PAVE, Prednisolone, Adriamycin (Doxorubicin), Vinblastine, Etoposide; PAVe, Procarbazine, Alkeran, Velban; RT, radiotherapy; VAMP, Vincristine (Oncovin), Adriamycin (Doxorubicin), Methotrexate, Prednisone; VBM, Velban, Bleomycin, Methotrexate; VELBE, Vinblastine.

Age at diagnosis and time of study reported in median years (range) or mean ± SD.

The number of patients that received pelvic radiotherapy as (part of their) cancer treatment is reported. If mentioned, (pelvic) radiation dosage is included.

Reference values for semen analysis are summarized in Supplementary Table SI.