Prostate brachytherapy does not always lead to infertility

Contrary to popular belief, men who undergo brachytherapy for prostate cancer are not always rendered infertile, according to the results of small case series.

Prostate brachytherapy has been shown to reduce the volume of semen and alter its viscosity. Moreover, men treated with this modality often experience erectile dysfunction. For these reasons, many researchers have assumed that these men are infertile.In a study reported in the October issue of BJU International, Dr. Joseph A. Grocela and colleagues, from Massachusetts General Hospital in Boston, describe three unintended pregnancies that occurred after the male partner was treated with prostate brachytherapy.Two of the pregnancies were carried to term, resulting in two healthy infants. The other pregnancy resulted in a spontaneous miscarriage in the first trimester.Although the men had low semen volumes and slightly decreased total sperm counts, the morphologic features of their sperm met most or all of the World Health Organization’s criteria for normal. Based on their estimates, the researchers believe these men received radiation doses to the testes of 0.03 to 2.5 Gy, which would be expected to have little or no effect on sperm germinal centers.”These three cases provide a cautionary tale and suggest that all men being treated with prostate brachytherapy should be counseled about possible continued fertility,” the authors state. (Source: BJU Int 2005;96:781-782: Reuters Health: Oncolink: November 2005.)