ESPE Abstracts

Background: Gonadal or sexual dysfunctions are common and important complications of childhood cancer survivors. But few studies have been conducted on these areas, and if any, they are only about gonadal dysfunctions. Semen quality or sexual functions were rarely investigated.

Objective and hypotheses: We purposed to evaluate prevalence of gonadal failure, semen abnormality, and sexual dysfunction of adolescent/young adult childhood cancer survivors. Risk factors for gonadal failure and semen abnormality were also evaluated. We also hypothesized that a romantic relationship will be affected by gonadal and sexual dysfunction.

Method: Demographic and medical characteristics were obtained from the patients’ medical records. Hormonal evaluation and semen analysis were performed. Sexual function and romantic relationship were evaluated via questionnaire.

Results: Included were childhood cancer survivors aged 15–30 years. More than 2 years should have passed after completion of therapy. Among the 88 participants, 45 (51.1%) were male. Median age at diagnosis and at study was 14.0 and 19.8 years respectively. 12 females (27.9%) needed sex hormone replacement, for which peripheral blood stem cell transplantation was a significant risk factor (P=0.004). Among the males, three had testis volume <15 cc, but none were on sex hormone replacement. On semen analysis, 12 among 24 subjects (50%) showed azo/oligospermia. Older age at diagnosis or cyclophosphamide equivalent dose more than 8 000 mg/m² was observed to increase risks for azo/oligospermia. 37 (18 males and 19 females) responded to the questions on sexual function. Erectile dysfunction was found in 13 among 18 males. Only six males and six females were in romantic relationship at the time of study. Only one among 13 males with erectile dysfunction and one among 12 females on sex hormone replacement had a lover.

Conclusion: A significant proportion of childhood cancer survivors have gonadal and sexual dysfunction, which is then thought to affect their romantic relationship. Thus, proper strategies for managing these complications are needed to improve their quality of life.