Transient Azoospermia Induced by Valganciclovir Treatment for Cytomegalovirus Infection in a Reproductive Male After Kidney Transplant: A Case Report

Q4 Medicine

IJU Case Reports Pub Date : 2025-06-05 DOI:10.1002/iju5.70060

Kosuke Mieda, Shunta Hori, Mitsuru Tomizawa, Kuniaki Inoue, Tatsuo Yoneda, Yuji Nitta, Yasushi Nakai, Makito Miyake, Nobumichi Tanaka, Kiyohide Fujimoto

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Abstract

Introduction

Spermatogenic dysfunction is a side effect of valganciclovir, which is commonly used to treat cytomegalovirus infections. Here, we report the case of a reproductive man who underwent kidney transplantation and was diagnosed with azoospermia after valganciclovir treatment for cytomegalovirus infection.

Case Presentation

A 30-year-old man underwent an ABO-compatible living-donor kidney transplantation. Two months after the kidney transplant, the patient was diagnosed with cytomegalovirus infection and gastritis. Therefore, valganciclovir treatment was initiated. Two months after completion of valganciclovir treatment, the patient was diagnosed with azoospermia. Azoospermia induced by valganciclovir was suspected, and careful monitoring was performed. Nine months after azoospermia diagnosis, the sperm concentration improved to normal range (43.3 × 10⁶/mL). Subsequently, the patient's wife conceived.

Conclusion

During valganciclovir treatment, careful monitoring and adequate informed consent are needed to support patients of reproductive age.

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缬更昔洛韦治疗肾移植后巨细胞病毒感染致一过性无精子症1例

生精功能障碍是缬更昔洛韦的一个副作用，缬更昔洛韦常用于治疗巨细胞病毒感染。在此，我们报告一例接受肾移植的生殖男性，在接受缬更昔洛韦治疗巨细胞病毒感染后被诊断为无精子症。一例30岁男性接受abo相容活体肾移植。肾移植两个月后，患者被诊断为巨细胞病毒感染和胃炎。因此，开始使用缬更昔洛韦治疗。在完成缬更昔洛韦治疗两个月后，患者被诊断为无精子症。怀疑缬更昔洛韦所致无精子症，进行严密监测。诊断无精子症9个月后，精子浓度恢复到正常范围（43.3 × 106/mL）。随后，病人的妻子怀孕了。结论在缬更昔洛韦治疗期间，需要认真监测和充分的知情同意，以支持育龄患者。

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