Transrectal ultrasound guided biopsy of the prostate appears to have an immediate impact on semen parameters, according to a new study. In some patients, these changes are sustained at two to four months.

In recent years, the age of men undergoing transrectal ultrasound guided prostate biopsy (TUSGBx) has been decreasing. Thus, younger men who are likely to be more concerned with their fertility are undergoing prostate biopsy.

The authors of a study presented at the American Urological Association's Annual Meeting hypothesized that transrectal ultrasound guided biopsy of the prostate may have affect semen parameters and fertility. A prospective study was conducted of men undergoing prostate biopsy. Semen analyses were prior to biopsy and one week after and two to four months following biopsy.

Semen parameters assessed included:

1) ejaculate volume
2) sperm concentration
3) total sperm count and
4) total motile sperm counts.

Sperm concentration decreased in five of 12 patients (average 44 per cent; specimen 1 vs. 2). Two of the seven men providing a third specimen demonstrated a decreased sperm concentration. The average percentage decrease for those two patients was 41 per cent.

Three of the seven men that provided a third specimen had total sperm counts that remained decreased (average 35 per cent) from their pre-biopsy specimen. Total motile sperm counts decreased (average 35 per cent) in seven out of 12 patients from specimen 1 to 2. Of the seven men that provided a third specimen, three had total motile sperm counts that remained decreased (average 43 per cent) from their pre-biopsy specimen.

The authors concluded that transrectal ultrasound guided biopsy of the prostate does appear to have an immediate impact on semen parameters. In some patients, these changes are sustained at two to four months.

Editorial comment:

This study raises and addresses and important clinical question that needs to be resolved as more younger men are subjected to prostate biopsies. The possibility that fertility may be adversely impacted in some patients should be discussed. This may be important for some men who may have impaired semen parameters prior to biopsy. Further investigation is warranted.

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