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Esposizione professionale a chemioterapici antiblastici - Bibliomed

Esposizione professionale a chemioterapici antiblastici - Bibliomed

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aumentati, mentre il testosterone rimane a livelli normali. Alcuni autori riportano una<br />

diminuzione della libido nel 70% dei pazienti sottoposti a chemioterapia e il 40% mantiene il<br />

disturbo anche dopo la sospensione della terapia; mentre l’impotenza sembra essere un sintomo<br />

transitorio (19, 21, 22).<br />

Tra i vari farmaci impiegati è la ciclofosfamide quella che sembra avere gli effetti maggiori<br />

sulla funzione testicolare con produzione di azoospermia persistente; Kreuser in un lavoro del<br />

1988 riportava nel follow -up a 11 anni azoospermia nel 100% dei casi trattati con COOP<br />

(ciclofosfamide, vinvristina, procarbazina, prednisone) (23).<br />

Schemi terapeutic i con ABVD (adriamicina, bleomicina, vinblastina, decarbazina)<br />

producono oligozoospermia e azoospermia con recessione completa dopo 1 anno dalla fine del<br />

trattamento.<br />

Bibliografia<br />

1. Mastroianni L, Paulsen CA (Ed.). Aging, reproduction, and the climateric . New York and London:<br />

Plenum Press; 1986.<br />

2. Metz CB, Monroy A (Ed.). Biology of ferilization . Orlando: Accademic Press; 1985.<br />

3. Lippes J, Enders RG, Pragay DA, Bartholomew WR. The collection and analysis of human<br />

fallopian tube fluid. Contraception 1982; 5(2):85-103.<br />

4. Diaz S, Ortiz ME, Croxatto HB. Studies on the duration of ovum transport by the human oviduct.<br />

The time interval between the luteinizing hormone peak and recovery of ova by transcervical<br />

flushing of’ the uterus in normal women. Am J Obstet Gynecol 1980;137:116.<br />

5. Coutinho EM, Mala HS. The contractile response of the human uterus, fallopian tubes and ovary to<br />

prostaglandins in vivo. Fertil Steril 1971;22:539-43.<br />

6. Deiìnker HW. Basic aspects of ova implantation. Obstet Gynecol Ann 1983;12:15 -42.<br />

7. Glasser SR. Current concepts of implantation and decidualization. In: Hoszar C (Ed). The<br />

physiology and biochemistry of the uterus in pregnancy and labor . Boca Raton, Florida; 1986.<br />

8. Mastroianni L, Biggers J (Ed.). Fertilization and embryonic development in vitro. New York:<br />

Plenum Press; 1982.<br />

9. Mann T, Lutwak-Mann C. Male reproductive function and semen . New York: Springer-Verlag;<br />

1981.<br />

10. Haas GG, Beer AE. Immunologic influences on reproductive biology: Sperm-gametogenesis and<br />

maturation in the male and female genital tracts. Fertil Steril 1986; 46:753-66.<br />

11. Bardin CW, Sherins RJ (Ed.). The cell biology of the testis. Ann NY Acad Sci 1982; 383.<br />

12. Yen SSC. The human menstrual cycle. In: Yen SSC, Jaffe RB (Ed.). Reproductive endocrinology .<br />

Philadelphia: Saunders; 1986. p. 200 -36.<br />

13. Harper NJK. Gamete and zygote transport. In: Knobil E, Neill J (Ed.). The physiology of<br />

reproduction . New York: Raven Press; 1988. p. 103-34.<br />

14. Candell FR, Swerdeloff RS. Role of temperature in regulation of spermatogenesis and the use of<br />

heating as a method of contraception. Fertil Steril 1988;49:1 -23.<br />

15. Russell LD. Spermiation – the sperm release process: ultrastructural observations and unresolved<br />

problems. In: Van Blerkom J, Motta PM (Ed.). Ultrastructure of reproduction . The Hague:<br />

Martinus Nijhoff; 1984. p. 46-66.<br />

16. Romagnolo C, Marchesini D, Maggino T. Antiblastic chemoterapy and reproductive life. Clin Exp<br />

Obstet Gynecol 1988;15:38-46.<br />

43

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