| Popis: |
A 33-year-old male with a history of Hodgkin lymphoma at age 14 presents with his wife to discuss fertility. He and his wife have been attempting pregnancy for the last 1 year, without success. His wife has recently undergone fertility testing and results thus far have been normal. She has regular menses, is not on birth control pills, and has achieved no prior pregnancies. The patient does not remember having a discussion about his fertility at the time of his lymphoma diagnosis. He had achieved puberty at the time of cancer treatment but did not cryopreserve sperm. The patient does have a history of chemotherapy, radiation therapy, and stem cell transplant. He does not report any recent fevers or history of urological trauma, including testicular torsion. He does not report a history of prostatitis, epididymitis, or orchitis. He denies a history of post-pubertal mumps. There is no known family history of fertility problems. He is not taking any current medications. He is able to find his lymphoma treatment history and reports that he was treated with Cytoxan, Adriamycin, vincristine, IV methotrexate, intrathecal methotrexate and ARA-C, ifosfamide, VP-16, L-asparaginase, and cisplatin. He received 2500 cGy of mini-mantle radiation. He received his bone marrow transplant 2 years after the initial diagnosis and was treated with ARA-C, VP-16, cisplatin, thiotepa, and Cytoxan. On exam, his penile exam is normal, with no evidence of plaques or induration. His urethral meatus is normal. His testes are descended bilaterally with no evidence of abnormal masses or tenderness. Both testes are 10 cc in volume. The epididymis, vas deferens, and cord structures are normal bilaterally. |
