(626) Impact of Primary Chemotherapy for Hodgkin Lymphoma on Hormonal Profile and Spermatogenesis: Results from a Single-Tertiary Referral Centre

Introduction The impact of primary chemotherapy for Hodgkin lymphoma on spermatogenesis and hormonal changes remains poorly understood. Objective We studied hormonal and sperm parameter changes at 12 months in patients undergoing chemotherapy for Hodgkin lymphoma. Methods Data from 72 patients who underwent ABVD (Adriamycin, Bleomycin, Vinblastine, Dacarbazine) after cryopreservation at a single tertiary center (Fundación Puigvert, Andrology Unit) were analyzed. Hormonal and semen parameters were collected at baseline and one year post-treatment, including total testosterone (tT), FSH, LH, seminal volume, sperm concentration, motility, and total motile sperm count (TMSC). Hypogonadism was defined as tT <3.5 ng/mL and TMSC decrease as <20 million at followup. Differences were assessed by Wilcoxon and McNemar tests. Vertical scatter plots showed seminal changes. Logistic regression identified predictors of significant TMSC decrease. Results Overall, median (IQR) age and median (IQR) BMI were 31 (25-38 yrs) and 23.1 (20.4-26.2 kg/m2). As for hormonal values, higher median (IQR) tT levels [20 (16.5-22) vs. 14 (11-17) ng/ml, p<0.001], but no significant changes in FSH [4.1 (2.9-7.8) vs. 3.2 (2.4-4.5) mUI/ml] and LH [5.5 (4.1-7.5) vs. 5.3 (4.0-7.0) mUI/ml] levels (p>0.05), were observed at follow-up. No patient developed hypogonadism. Sperm concentration [14 (1-43) vs. 36 (12-65) million/mL, p=0.03] and sperm motility [22 (8-44) vs. 40 (23-52), p=0.01] were significantly lower at follow-up compared to baseline; conversely, although reduced, median TMSC [18 (1-61) vs 27 (4-68) x106, p=0.4] did not reach statistical significance. Of note, at follow-up a greater proportion of patients presented with low TMSC (54% vs 46%, p=0.01) and azoospermia (13% vs 1.4%, p<0.001) compared with baseline. At logistic regression analysis, baseline TMSC was the only independent predictor of a clinically significant post-treatment decrease. Higher baseline TMSC values (OR:0.97, 95%CI: 0.94-0.99, p=0.01) were associated with a lower risk of post-treatment decline. Conclusions Despite overall hormonal stability, ABVD chemotherapy for Hodgkin lymphoma caused a significant decrease in TMSC and azoospermia at one year. These results suggest primary chemotherapy mainly impairs spermatogenesis rather than endocrine function. A good baseline TMSC appears protective for fertility recovery after treatment. Disclosure No