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Ipsilateral fertility (IF) is present in nearly half of patients undergoing radical orchiectomy for germ-cell tumors (GCT). Maximal tumor diameter (MTD) does not predict IF, supporting routine pre-orchiectomy sperm banking.

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Area of Science:

  • Reproductive Medicine
  • Oncology
  • Urology

Background:

  • Germ-cell tumors (GCT) significantly impact male fertility, with subfertility affecting nearly 50% of patients.
  • Fertility can be further compromised by GCT treatments, necessitating fertility preservation strategies like sperm banking before radical orchiectomy.
  • The contribution of the affected testis to fertility remains uncertain, highlighting the need for predictive markers.

Purpose of the Study:

  • To investigate the correlation between maximal tumor diameter (MTD) and ipsilateral fertility (IF) in patients treated for GCT.
  • To assess the prevalence of ipsilateral fertility in patients undergoing orchiectomy for GCT.

Main Methods:

  • Retrospective review of 57 GCT patients undergoing orchiectomy (1999-2015) for demographic and clinical data.
  • Assessment of spermatogenesis (full, hypospermatogenesis, absence) and presence of mature epididymal spermatozoa.
  • Definition of IF as full spermatogenesis (>100 tubules) and presence of mature epididymal spermatozoa; Mann-Whitney test used for MTD correlation analysis.

Main Results:

  • Ipsilateral fertility (IF) was observed in 28 out of 57 patients (49%).
  • No statistically significant correlation was found between maximal tumor diameter (MTD) and ipsilateral fertility (IF).
  • Full spermatogenesis was present in 57.8% and mature epididymal spermatozoa in 82.7% of patients.

Conclusions:

  • Ipsilateral fertility (IF) is present in approximately half of patients undergoing radical orchiectomy for GCT.
  • Maximal tumor diameter (MTD) is not a reliable predictor of ipsilateral fertility (IF).
  • Routine sperm banking prior to radical orchiectomy is recommended due to the unpredictability of fertility status.