Parameters Associated with Sperm Quality Prior to Chemotherapy Treatment in Patients with Lymphoma

Introduction: Chemotherapy treatment in patients with lymphoma may cause reduction in sperm quality. Therefore, patients are strongly advised to undergo sperm cryopreservation prior to the initiation of treatment. It is still unknown what are the factors in these patients that increase semen analysis abnormalities before chemotherapy.

Aim: Examine the relationship between known prognostic factors in lymphoma and sperm quality prior to chemotherapy treatment

Methods and materials: Retrospective cohort study including patients with lymphoma attempting sperm cryopreservation in Hadassah medical center between 1999-2016. Excluded were patients with known subfertility risks. Sperm was assesed according to WHO 2009 guidelines. Lymphoma prognostic factors were according to International Prognostic Score.

Results: The study included 191 patients – 101 had Hodgkin lymphoma and 90 had Non Hodgkin lymphoma. Among the prognostic factors for lymphomas, the following factors were associated with reduced sperm quality: B symptoms (p=0.021), albumin (p<0.001) and hemoglobin (p<0.001) levels. Logistic regression showed significant association of albumin and hemoglobin indexes with reduced sperm quality (p= 0.013, OR=2.7 and p= 0.015, OR=13.5, respectively). However, in Hodgkin`s lymphoma only hemoglobin was found to be significant. Another measure that showed a significant relationship was the Prognostic Score Ratio (PSR) (p<0.001), an index represents the number of negative prognostic measures in a given patient.

Conclusions: The study shows a link between prognostic factors of lymphoma and sperm quality pirior to chemotherapy. These prognostic factors are related to a general inflammatory state. This inflammation processes may affect sperm production.