儿童期促性腺毒素治疗后精子发生:12例患者的随访。

IF 8.3 Q1 OBSTETRICS & GYNECOLOGY
E Delgouffe, A Braye, V Vloeberghs, I Mateizel, C Ernst, A Ferster, C Devalck, H Tournaye, I Gies, E Goossens
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引用次数: 1

摘要

研究问题:儿童期假定的促性腺毒素治疗对患者成年后睾丸功能的长期影响是什么?虽然大多数患者在儿童期促性腺毒素治疗后12.3(2.3-21.0)年表现出睾丸体积低和一定程度的生殖激素紊乱,但12例患者中有8例的精液样本显示出活跃的精子发生。已知情况:近几十年来,已经建立了实验性睾丸组织库计划,以保障需要化疗和/或放射治疗的年轻男孩未来的生育能力,这些男孩具有明显的促性腺毒性。虽然这些治疗后无精子症的风险估计很高,但只有有限的关于成年期生殖潜力的长期数据。研究设计规模持续时间:该单中心前瞻性队列研究于2020年9月至2023年2月进行,涉及12名成年患者。参与者/材料设置方法:本研究在三级保健中心进行,包括12名年轻成年人(18.1-28.3岁),他们在儿童时期接受促性腺毒素治疗之前接受了睾丸组织库。所有患者都接受了生育专家的咨询和体格检查,进行了阴囊超声检查以测量睾丸体积和评估睾丸实质,进行了血液检查以评估生殖激素,并进行了精液分析。主要结果和偶然性的作用:12例患者中有10例在使用促性腺激素治疗前已将睾丸组织储存起来。9例患者睾丸体积低,10例患者出现不同程度的生殖激素紊乱。值得注意的是,在治疗后中位12.3年(范围2.3-21.0年),8名患者显示出持续的精子发生。注意事项:本研究样本量有限,需要对更大的研究人群进行额外的研究来验证这些初步发现。研究结果的更广泛意义:这些发现强调需要多中心研究和更大的研究人群来建立未成熟睾丸组织库的普遍纳入标准。研究经费/竞争利益:本研究由弗兰德斯研究基金会(G010918N)、Kom Op Tegen Kanker和科学基金Willy Gepts (WFWG19-03)的研究计划资助。作者声明没有利益冲突。试验注册号:NCT04202094;https://clinicaltrials.gov/ct2/show/NCT04202094?id=NCT04202094&draw=2&rank=1本研究于2019年12月6日注册,第一位患者于2020年9月8日入组。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Spermatogenesis after gonadotoxic childhood treatment: follow-up of 12 patients.

Spermatogenesis after gonadotoxic childhood treatment: follow-up of 12 patients.

Study question: What is the long-term impact of presumed gonadotoxic treatment during childhood on the patient's testicular function at adulthood?

Summary answer: Although most patients showed low testicular volumes and some degree of reproductive hormone disruption 12.3 (2.3-21.0) years after gonadotoxic childhood therapy, active spermatogenesis was demonstrated in the semen sample of 8 out of the 12 patients.

What is known already: In recent decades, experimental testicular tissue banking programmes have been set up to safeguard the future fertility of young boys requiring chemo- and/or radiotherapy with significant gonadotoxicity. Although the risk of azoospermia following such therapies is estimated to be high, only limited long-term data are available on the reproductive potential at adulthood.

Study design size duration: This single-centre prospective cohort study was conducted between September 2020 and February 2023 and involved 12 adult patients.

Participants/materials setting methods: This study was carried out in a tertiary care centre and included 12 young adults (18.1-28.3 years old) who had been offered testicular tissue banking prior to gonadotoxic treatment during childhood. All patients had a consultation and physical examination with a fertility specialist, a scrotal ultrasound to measure the testicular volumes and evaluate the testicular parenchyma, a blood test for assessment of reproductive hormones, and a semen analysis.

Main results and the role of chance: Testicular tissue was banked prior to the gonadotoxic treatment for 10 out of the 12 included patients. Testicular volumes were low for 9 patients, and 10 patients showed some degree of reproductive hormone disruption. Remarkably, ongoing spermatogenesis was demonstrated in 8 patients at a median 12.3 (range 2.3-21.0) years post-treatment.

Limitations reasons for caution: This study had a limited sample size, making additional research with a larger study population necessary to verify these preliminary findings.

Wider implications of the findings: These findings highlight the need for multicentric research with a larger study population to establish universal inclusion criteria for immature testicular tissue banking.

Study funding/competing interests: This study was conducted with financial support from the Research Programme of the Research Foundation-Flanders (G010918N), Kom Op Tegen Kanker, and Scientific Fund Willy Gepts (WFWG19-03). The authors declare no competing interests.

Trial registration number: NCT04202094; https://clinicaltrials.gov/ct2/show/NCT04202094?id=NCT04202094&draw=2&rank=1 This study was registered on 6 December 2019, and the first patient was enrolled on 8 September 2020.

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