ABSTRACT
Adult men Testicular damage due to chemotherapy was first reported in 1948, with a description of azoospermia in 27/30 men at autopsy following treatment with nitrogen mustard87. By the late 1960s there were also reports of testicular toxicity due to other alkylating agents (Table 1), namely busulfan, chlorambucil, cyclophosphamide and procarbazine88. Testicular biopsy
following such treatment shows aplasia of the germinal epithelium, atrophic tubules and peritubular fibrosis. These histological changes are associated with a reduction of testicular volume, reduced or absent sperm count and infertility. As with radiotherapy, chemotherapy is more toxic to the germinal epithelium than to the Leydig cells and animal studies indicate that the differentiating spermatogoonia are the most sensitive germ cells89. Although Leydig cells are more resistant to chemotherapy, significant rises in LH following chemotherapy indicative of Leydig cell dysfunction have been widely described90-94.
