Treatment with the gonadotropin-releasinghormone agonist buserelin to protect spermatogenesis against cytotoxic treatment in young men.

We treated 20 young men, after giving informed consent, with buserelin during their tumor treatment period. 11 of them suffered from Hodgkins disease, 2 had a non-Hodgkin lymphoma, 6 had a seminoma and 1 patient had an embryonic carcinoma of the testis. 7 of these patients received cytostatic treatment with MOPP and/or ABVD, 9 patients had a radiation treatment, 3 received both treatments. One patient remained free of further treatment. Buserelin treatment was recommended to start at least 7 days prior to the tumor treatment, the interval ranged between 7 and 43 days. It ended on the same day as the tumor treatment or some days later, but this recommendation was followed only in 12 patients. 4 patients cessated buserelin treatment before end of the tumor therapy, and 4 other dropped out of the study. Testosterone plasma levels were measured before, during and after treatment with buserelin. 7 days after starting they were increased in most patients, while they were lower after 14 days and at the end of treatment period. Semen analysis showed sperm counts of 1 to 44 millions/ml with motility rates from 9 to 81%. In only ten patients we analysed a semen sample up to 6 months after cessation of treatment. In all but one we found azoospermia. Thus this treatment at now cannot be recommended in young men undergoing cytotoxic treatment to preserve fertility.