Open AccessEffects of valganciclovir on spermatogenesis in renal transplant patients – results of a multicenter prospective nonrandomized study
Author(s) -
McLeroth Patrick,
Paduch Darius A.,
Abt Markus,
Hughes Richard,
Moore Suzanne,
Mudie Nadejda
Publication year - 2020
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.13558
Subject(s) - medicine , valganciclovir , cohort , prospective cohort study , urology , semen , sperm , nephrology , semen analysis , gastroenterology , sperm motility , infertility , andrology , ganciclovir , immunology , human cytomegalovirus , biology , pregnancy , virus , genetics
Summary Ganciclovir (GCV) inhibits spermatogenesis in preclinical studies but long‐term effects on fertility in renal transplant patients are unknown. In a prospective, multicenter, open‐label, nonrandomized study, male patients were assigned to Cohort A [valganciclovir (VGCV), a prodrug of GCV] ( n = 38) or B (no VGCV) ( n = 21) by cytomegalovirus prophylaxis requirement. Changes in semen parameters and DNA fragmentation were assessed via a mixed‐effects linear regression model accounting for baseline differences. Sperm concentration increased post‐transplant, but between baseline and treatment end (mean 164 days Cohort A, 211 days Cohort B), the model‐based change was lower in Cohort A (difference: 43.82 × 10 6 /ml; P = 0.0038). Post‐treatment, sperm concentration increased in Cohort A so that by end of follow‐up (6 months post‐treatment) changes were comparable between cohorts (difference: 2.09 × 10 6 /ml; P = 0.92). Most patients’ sperm concentration improved by end of follow‐up; none with normal baseline concentrations (≥20 × 10 6 /ml) were abnormal at end of follow‐up. Changes in seminal volume, sperm motility/morphology, DNA fragmentation, and hormone levels were comparable between cohorts at end of follow‐up. Improvement in semen parameters after renal transplant was delayed in men receiving VCGV, but 6 months post‐treatment parameters were comparable between cohorts.