Spermatogenesis and hormonal status after orchiectomy for cancer and before supplementary treatment

Low numbers of sperm cells (less than 20 million/ml), low motility indices (less than 40) and/or a high percentage of abnormal sperm cells (greater than 80%) were found in about half of 60 patients with testicular cancer after orchiectomy and before further treatment. There was no correlation between these findings and the patient's age, tumor histology or clinical stage. Relatively low serum testosterone values in the majority of patients and increased serum LH and FSH in some patients also indicated disturbed gonadal function at the time of fertility evaluation. The clinical significance of cryopreservation of sperm cells is therefore questionable in the majority of these patients. The demonstrated hypofertility after orchiectomy and before further treatment for testicular cancer may, however, be reversible at least in some patients. In patients with testicular cancer every attempt should be made to preserve the patients' fertility during the necessary diagnostic and therapeutic procedures, without a reduction in the high cure rate which is obtained by modern multimodal treatment of testicular cancer.