Fertility among testicular cancer survivors: a case-control study in the U.S.
- 187 Downloads
Testicular germ cell tumors (TGCT) disproportionately affect men between the ages of 15 and 49 years, when reproduction is typical. Although TGCT treatment directly affects gonadal tissues, it remains unclear whether there are long-term effects on fertility.
To examine post-TGCT treatment fertility, study participants in a previously conducted case-control study were contacted. The men were initially enrolled in the US Servicemen’s Testicular Tumor Environmental and Endocrine Determinants (STEED) study between 2002 and 2005. A total of 246 TGCT cases and 236 controls participated in the current study and completed a self-administered questionnaire in 2008–2009.
TGCT cases were significantly more likely than controls to experience fertility distress (OR 5.23; 95% CI 1.99–13.76) and difficulty in fathering children (OR 6.41; 2.72–15.13). Cases were also more likely to be tested for infertility (OR 3.65; 95% CI 1.55–8.59). Cases, however, did not differ from controls in actually fathering children (OR 1.37; 95% CI 0.88–2.15). These findings were predominantly observed among nonseminoma cases and cases treated with surgery only or surgery-plus-chemotherapy.
While expressing greater fertility distress, higher likelihood of fertility testing, and difficulty fathering children, these data suggest that TGCT survivors are no less likely to father children than are other men. It is possible that treatment for TGCT does not permanently affect fertility or, alternatively, that TGCT survivors attempt to father children with greater persistence or at younger ages than do other men.
KeywordsFertility Testicular cancer Epidemiology
This study is supported by grant CA130110 from the National Cancer Institute (NCI) and by Fogarty training grants 1D43TW008323-01 and 1D43TW007864-01 from the National Institute of Health (NIH). This publication was made possible by CTSA Grant number UL1 RR024139 from the National Center for Research Resources (NCRR), a component of the NIH and NHL roadmap for medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR. The authors are greatly indebted to the Study participants, without whom, there would have been no study. The opinions or assertions contained herein are the private views of the author, and are not to be construed as official, or as reflecting true views of the Department of the Army or the Department of Defense.
- 1.American Cancer Society. Inc. Cancer Reference Information 2009. Atlanta: American Cancer Society, Inc; 2009.Google Scholar
- 3.Shetty G, Meistrich ML. Hormonal approaches to preservation and restoration of male fertility after cancer treatment. J Natl Cancer Inst. 2005;34:36–9.Google Scholar
- 12.Arai Y, Kawakita M, Okada Y, Yoshida O. Sexuality and fertility in long-term survivors of testicular cancer. J Clin Onc. 1997;15:1444–8.Google Scholar
- 16.Rieker PP, Edbril SD, Garnick MB. Curative testis cancer therapy: psychosocial sequelae. J Clin Onc. 1985;3:1117–26.Google Scholar
- 18.Andrews FM, Abbey A, Halman LJ. Is the fertility-problem stress different? The dynamics of stress in fertile and infertile couples. Fertil Steril. 1993;57(6):1247–53.Google Scholar
- 25.TRICARE Beneficiaries. http://www.tricare.mil
- 26.Department of Veterans Affairs. http://www.va.gov