Impact of testicular cancer stage on semen parameters in patients before orchiectomy

To study the impact of testicular cancer composite stage and histology with semen parameters in preorchiectomy cryopreservation samples.

We retrospectively collected semen parameter data, composite stage, and tumor histology for patients who cryopreserved sperm prior to orchiectomy for testicular cancer between 2006 and 2018. Stage I was considered localized disease, and Stages II and III were considered metastatic disease. The World Health Organization (WHO) 2010 semen parameter criteria was used to characterize lab values as normal or subnormal. Categorical and continuous variables were compared using Fisher's exact and Mann Whitney U tests, respectively.

Thirty eight patients with testicular cancer underwent preorchiectomy cryopreservation. The median age (IQR) of our cohort was 27 (23-32). Four patients (11%) had azoospermia. No significant differences were found in these semen parameters between Stage I and Stage II/III patients or between seminoma and NSGCT patients. Per WHO 2010 criteria, 7 patients (18%) had abnormal (below reference range) semen volume, 18 patients (47%) had abnormal total sperm counts, and 9 patients (24%) had abnormal motility percentage. Abnormal semen parameters were not significantly associated with tumor histology or stage.

To our knowledge, this is the first study to show that semen parameters are similar across all stages of testicular cancer. Prior studies have shown that delaying orchiectomy to cryopreserving sperm does not negative affect oncological outcomes. As a result, regardless of staging or histology, sperm banking should be recommended for patients with both localized and metastatic testicular cancer.