Long-term infertility and dominant lethal mutations in male mice treated with adriamycin.

Sperm production and fertility were studied in male mice treated with adriamycin (ADR) at 6 or 8 mg/kg. Testicular sperm production and epididymal sperm counts were markedly reduced after ADR treatment. Gradual recovery of counts occurred, but sperm counts had not reached control levels even more than 1 year after treatment. Epididymal sperm showed treatment-induced morphological abnormalities throughout the experiment; the frequencies of sperm with detached tails and the frequencies of sperm with morphologically abnormal heads remained elevated about 2-3-fold above control. According to the frequency of vaginal plugs, treated male mice mated at control rates with untreated females during the post-treatment sterile period. However, after some fertility was regained the fertilization rate (calculated as the fraction of eggs, flushed from the oviduct 2 days after mating, that had been fertilized and had cleaved) was markedly reduced and remained depressed for the remainder of the experiment. The fertilization rate reached only 0.29 at 23-32 weeks after 8 mg/kg ADR and 0.76 at 16-23 weeks after 6 mg/kg ADR; both values were significantly below the control value of 0.94. Dominant lethal mutations in the zygotes flushed from the oviduct were measured in culture by the loss of the zygote's ability to develop to a stage characterized by trophectoderm outgrowths and formation of an inner cell mass. The frequencies of dominant lethal mutations detected in vitro were 1.7 or 7.4% after 6 mg/kg, and 32 or 40% after 8 mg/kg ADR; each value was calculated in two different ways, with 3 of these 4 values significantly different from zero. We conclude that even after mice regain fertility following ADR exposure, the level of fertility remains permanently subnormal as evidenced by a lack of fertilization of eggs that is probably due to the decreased quantity and quality of spermatozoa produced. Furthermore, ADR can induce genetic damage in stem spermatogonia, which can be transmitted through fertile spermatozoa. Thus, there may be a genetic risk to the offspring of cancer patients treated with ADR chemotherapy, but at present we are unable to quantitate that risk.