Organ-sparing surgery does not lead to greater antisperm antibody levels than orchidectomy

To assess a possible development of antisperm antibodies (ASA), present in a high percentage of infertile patients, after organ-sparing surgery for small testicular tumours, to identify any additional immunogenic effect of this procedure compared with standard orchidectomy.

Samples of sera were assessed from 54 men who had had surgery between 2000 and 2005 for testicular tumour; the men were divided into two groups, i.e. group A (23) had had organ-sparing tumour resection and group B (31) had had inguinal orchidectomy. Other possible causes of ASA besides testicular tumour were excluded in all patients. The blood samples were obtained during follow-up visits and the circulating ASA in serum determined using an enzyme-linked immunosorbent assay.

The mean (range) tumour diameter was statistically significantly greater (P < 0.03) in group B, at 33.6 (2-130) mm, than in group A, at 12 (2-30) mm. There were significantly more stromal tumours in group A than group B (P < 0.02). Most importantly, the mean (range) ASA levels were not statistically significantly (P > 0.3) higher in group A, at 29 (15-59) U/mL, than in group B, at 24.8 (12-39) U/mL. There was also no statistically significant correlation between ASA levels and clinical stage, length of follow-up after therapy, patient age, tumour size and type of histology.

From these data, organ-sparing surgery does not lead to greater ASA levels than orchidectomy and patients are therefore at no greater risk of developing an autoimmune infertility.