COSA:AYA fertility preservation/Impact of cancer treatments on fertility/Table effect of cancer treatments on sperm production

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Fertility preservation for AYAs diagnosed with cancer: Guidance for health professionals. > COSA:AYA fertility preservation/Impact of cancer treatments on fertility/Table effect of cancer treatments on sperm production

Table 3: Effect of cancer treatments on sperm production in males

Degree of risk Treatment Common usage
High risk: prolonged azoospermia after treatment Total body irradiation Bone marrow transplantation, Stem cell transplantation (BMT/SCT)
Testicular radiation dose > 2.5 Gy in men Testicular cancer, ALL, NHL
Testicular radiation dose ≥ 6 Gy in boys ALL, NHL, sarcoma, germ cell tumours
Protocols containing procarbazine: COPP, MOPP (83% risk) [1], MVPP (97% risk) [1], ChIVPP, ChIVPP/EVA, MOPP/ABVD, COPP/ABVD (62% risk) [1] Hodgkin lymphoma
Alkylating chemotherapy for transplantation conditioning (cyclophosphamide, busulfan, melphalan)(70% risk) [1] BMT/SCT
Any alkylating agent (eg, procarbazine, nitrogen mustard, cyclophosphamide) + TBI (80-90% risk) [1], pelvic radiation, or testicular radiation Testicular cancer, BMT/SCT, ALL, NHL, sarcoma, neuroblastoma, Hodgkin lymphoma
BEACOPP (67-80% risk) [1] Hodgkin lymphoma
Cyclophosphamide > 7.5 g/m2 Sarcoma, NHL, neuroblastoma, ALL
Cranial/brain radiation ≥ 40 Gy Brain tumour
Intermediate risk: prolonged azoospermia not common at standard dose BEP × 2-4 cycles Testicular cancer
Cumulative cisplatin dose < 400 mg/m2 Testicular cancer
Cumulative carboplatin dose ≤ 2 g/m2 Testicular cancer
Testicular radiation dose 1-6 Gy (as a result of scatter from abdominal/pelvic radiation) Wilms tumour, neuroblastoma
Low risk: temporary azoospermia after treatment Lower dose alkylating chemotherapy: ABVD (8% risk) [1], OEPA, NOVP, CHOP, COP Hodgkin lymphoma, NHL
Testicular radiation dose 0.2-0.7 Gy Testicular cancer
Very low/no risk: no effects on sperm production Testicular radiation dose < 0.2 Gy Multiple cancers
Interferon alfa Multiple cancers
Radioactive iodine Thyroid cancer
Unknown risk Irinotecan Colon cancer
Bevacizumab Colon, non–small-cell lung cancer
Cetuximab Colon, head and neck cancer
Erlotinib Non–small-cell lung, pancreatic cancer
Imatinib Chronic myeloid leukemia, GI stromal tumor

Source: Levine J, Canada A, Stern CJ. Fertility preservation in adolescents and young adults with cancer J Clin Oncol 2010 Nov 10;28(32):4831-41 [Available at].


  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Leader A, Lishner M, Michaeli J, Revel A. Fertility considerations and preservation in haemato-oncology patients undergoing treatment. Br J Haematol 2011 May;153(3):291-308 Abstract available at