Impact of chemotherapy and radiotherapy for testicular germ cell tumors on spermatogenesis and sperm DNA: a multicenter prospective study from the CECOS network  Louis Bujan, M.D., Ph.D., Marie Walschaerts, Ph.D., Nathalie Moinard, D.Pharm., Sylvianne Hennebicq, M.D., Ph.D., Jacqueline Saias, M.D., Florence Brugnon, M.D., Ph.D., Jacques Auger, M.D., Ph.D., Isabelle Berthaut, Ph.D., Ethel Szerman, Ph.D., Myriam Daudin, M.D., Nathalie Rives, M.D., Ph.D.  Fertility and Sterility  Volume 100, Issue 3, Pages 673-680.e2 (September 2013) DOI: 10.1016/j.fertnstert.2013.05.018 Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 1 Mean of total sperm count and standard error of the mean before treatment and during posttreatment follow-up observation according to treatment type (radiotherapy, 1–2 BEP cycles, >2 BEP cycles). *P<.05, before and after treatment difference. #P<.05, difference between treatments. Mean ± standard deviation is given at each time point. Fertility and Sterility 2013 100, 673-680.e2DOI: (10.1016/j.fertnstert.2013.05.018) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Figure 2 Recovery of total sperm count ≥39 × 106/ejaculate after treatment. P value indicates the difference between groups using the log-rank test. Hazard ratios (HR) and 95% confidence intervals (CIs) were obtained from a univariate Cox model. The cumulative success rates of semen recovery were estimated by the Kaplan-Meier method, stratified according to: (A) type of testicular germ cell tumor: 85% (95% CI, 75–93) for seminoma and 70% (95% CI, 57–83) for nonseminoma; (B) the type of treatment: 63% (95% CI, 48–79) for chemotherapy ≤2 cycles, 92% (95% CI, 70–99) for chemotherapy >2 cycles, and 86% (95% CI, 76–94) for radiotherapy; and (C) the total sperm count before treatment: 61% (95% CI, 46–76) for total sperm count (TSC) <39 × 106 and 89% (95% CI, 80–96) for TSC ≥39 × 106; (D) history of cryptorchidism: 81% (95% CI, 73–89) for no cryptorchidism and 55% (95% CI, 30–84) for cryptorchidism. Fertility and Sterility 2013 100, 673-680.e2DOI: (10.1016/j.fertnstert.2013.05.018) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions

Supplemental Figure 1 Design of the prospective study. Fertility and Sterility 2013 100, 673-680.e2DOI: (10.1016/j.fertnstert.2013.05.018) Copyright © 2013 American Society for Reproductive Medicine Terms and Conditions