Long-term male fertility after treatment with radioactive iodine for differentiated thyroid carcinoma

in European Journal of Endocrinology
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  • 1 Department of Endocrinology, Internal Medicine
  • | 2 Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
  • | 3 Department of Internal Medicine and Erasmus MC Academic Center for Thyroid Disease, Erasmus Medical Center, Rotterdam, the Netherlands
  • | 4 Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
  • | 5 Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
  • | 6 Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
  • | 7 Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
  • | 8 Division of Endocrinology and Metabolism, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands

Correspondence should be addressed to T P Links Email t.p.links@umcg.nl
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Context

Whilst radioactive iodine (RAI) is often administered in the treatment for differentiated thyroid carcinoma (DTC), long-term data on male fertility after RAI are scarce.

Objective

To evaluate long-term male fertility after RAI for DTC, and to compare semen quality before and after RAI.

Design, setting, and patients

Multicenter study including males with DTC ≥2 years after their final RAI treatment with a cumulative activity of ≥3.7 GBq.

Main outcome measure(s)

Semen analysis, hormonal evaluation, and a fertility-focused questionnaire. Cut-off scores for ‘low semen quality’ were based on reference values of the general population as defined by the World Health Organization (WHO).

Results

Fifty-one participants had a median age of 40.5 (interquartile range (IQR): 34.0–49.6) years upon evaluation and a median follow-up of 5.8 (IQR: 3.0–9.5) years after their last RAI administration. The median cumulative administered activity of RAI was 7.4 (range: 3.7–23.3) GBq. The proportion of males with a low semen volume, concentration, progressive motility, or total motile sperm count did not differ from the 10th percentile cut-off of a general population (P = 0.500, P = 0.131, P = 0.094, and P = 0.500, respectively). Cryopreserved semen was used by 1 participant of the 20 who had preserved semen.

Conclusions

Participants had a normal long-term semen quality. The proportion of participants with low semen quality parameters scoring below the 10th percentile did not differ from the general population. Cryopreservation of semen of males with DTC is not crucial for conceiving a child after RAI administration but may be considered in individual cases.

Supplementary Materials

    • Supplemental Table 1. Assay information for Hormonal Measurements in Male Participants treated with Radioactive Iodine for Differentiated Thyroid Carcinoma
    • Supplemental Table 2. Treatment characteristics of participants treated with radioactive iodine for differentiated thyroid carcinoma
    • Supplemental Table 3. Pathology Characteristics of Male Participants treated with Radioactive Iodine for Differentiated Thyroid Carcinoma
    • Supplemental Table 4. Semen Characteristics of Participants treated with Radioactive Iodine for Differentiated Thyroid Carcinoma
    • Supplemental Table 5. Semen Characteristics of 51 Participants (22)
    • Supplemental Table 6. Associations between Treatment and Semen Characteristics in Participants treated with Radioactive Iodine for Differentiated Thyroid Carcinoma
    • Supplemental Figure 1. Overview of number of conceived pregnancies and pregnancy outcomes before and after treatment with a cumulative activity of at least 100 mCi/3.7 GBq of radioactive iodine (RAI) in 50 males diagnosed with differentiated thyroid carcinoma. For one participant who conceived two pregnancies, it was unknown if the pregnancies were conceived before or after RAI treatments. No participants reported having fathered children with congenital malformations or major health problems.

 

     European Society of Endocrinology

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