Fertility in patients with cancer of the testis before and after treatment: fertility after surgery

Abstract

The effects of treatments for cancer of the testis on fertility throw a shadow over the remarkable results which can be obtained with surgery, radiotherapy and above all chemotherapy. This is made more distressing by the fact that cancer of the testis occurs in young men, most of whom have not yet had children. This delicate problem has become an important issue, especially over the last few years. The study of effects of surgery on fertility in men with cancer of the testis is biased from the start, since this cancer occurs in the gland responsible for fertility and develops at the expense of the germinal cells. Few studies have examined the fertility of men with cancer of the testis just before their tumor was discovered. We simply know that the rate of “paternity” in relation to age is essentially the same as for a normal population. It is reasonable to think that the cancer alters spermatogenesis on the affected side and perhaps on the opposite side by an unexplained mechanism. Examination of the seminiferous tubules of orchidectomy specimens for small cancers very often reveals a marked alteration of spermatogenesis that may be due simply to a mechanical action.