Semen quality and fertility in adult long-term survivors of childhood acute lymphoblastic leukemia  Kirsi Jahnukainen, M.D., Ph.D., Risto Heikkinen, M.D., Markus Henriksson, M.D., Ph.D., Trevor G. Cooper, Ph.D., Leena-Riitta Puukko- Viertomies, M.D., Ph.D., Outi Mäkitie, M.D., Ph.D.  Fertility and Sterility  Volume 96, Issue 4, Pages 837-842 (October 2011) DOI: 10.1016/j.fertnstert.2011.07.1147 Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions

Figure 1 (A) Testicular volume and (B) total sperm count compared with the control group and acute lymphoblastic leukemia (ALL) survivors without testicular irradiation. Closed dots represent survivors with prophylactic cranial irradiation. P values are compared with the control group. Testis volume: control vs. cyclophosphamide 0 g/m2, P=.24; vs. ≤10 g/m2, P=.001; vs. >20 g/m2, P=.003. Total sperm count: control vs. cyclophosphamide 0 g/m2, P=.84; vs. ≤10 g/m2, P=.90; vs. >20 g/m2, P=.004. Fertility and Sterility 2011 96, 837-842DOI: (10.1016/j.fertnstert.2011.07.1147) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions

Figure 2 Cumulative fertility rates of first-fathered child by age of the father. The values for the 28-year and 33-year rates are mean ± standard error of the mean. TI = testicular irradiation ± cyclophosphamide. Controls vs. cyclophosphamide >20 g/m2 or TI, P<.05. Cyclophosphamide 0–10 g/m2 vs. >20 g/m2 or TI, P<.05. Fertility and Sterility 2011 96, 837-842DOI: (10.1016/j.fertnstert.2011.07.1147) Copyright © 2011 American Society for Reproductive Medicine Terms and Conditions