Effects of taxane-based chemotherapy on inhibin B and gonadotropins as biomarkers of spermatogenesis

Objective: To assess the effects of taxane-based chemotherapy on the male reproductive axis, and, therefore, its impact on spermatogenesis and fertility. Design: Controlled clinical study. Setting: Patients with cancer in an academic research environment. Patient(s): Forty male patients of reproductive age with cancer with solid tumor at diagnosis, who had been scheduled to receive taxane-based chemotherapy. Intervention(s): The patients were given treatment with docetaxel or paclitaxel combined with gemcitabine or carboplatin. Blood sampling and testicular ultrasonography were performed before and after completion of chemotherapy. Main Outcome Measure(s): In all patients, serum levels of inhibin B, FSH, and LH were measured, and, in half of the patients, bilateral testicular volume was also measured. Result(s): There was a statistically significant decrease in serum inhibin B and increase in serum FSH in all patients after the completion of the taxane-based chemotherapy. The median LH levels did not exhibit a statistically significant increase after the last cycle. Bilateral testicular volume exhibited a statistically significant decrease in 19 out of 20 patients (95%) after completion of chemotherapy. Conclusion(s): Taxane-based chemotherapy induces the reduction of inhibin B and the reciprocal elevation of FSH, which are associated with significant gonadal damage in the early stages after completion of chemotherapy. (Fertil Steril(R) 2010;94:558-63. (C) 2010 by American Society for Reproductive Medicine.)