Spermatogenesis after unilateral orchiectomy for testicular cancer in patients following surveillance policy.
OBJECTIVE
Only limited information is available on the natural course of spermatogenesis in patients with testicular cancer who underwent unilateral orchiectomy and surveillance. We analyze long-term exocrine function of the remaining testicle in patients following surveillance policy.


METHODS
Sperm counts and serum follicle-stimulating hormone (FSH) levels were available in 60 nonrelapsing cases approximately 3 weeks (baseline), 1 year and 2 years or greater after orchiectomy. Contralateral testicular cancer subsequently developed in 2 men.


RESULTS
At baseline 36 patients were normospermic (10 or greater x 106/ml.), 7 were azoospermic and 17 were oligospermic. After 1 year 45 patients were normospermic. Mean sperm concentrations increased significantly from 26 to 39 x 106/ml. during year 1 after orchiectomy. Elevated serum FSH at baseline was associated with incomplete recovery of spermatogenesis, although sperm counts improved in 3 of 7 patients. Furthermore, in the 2 initially oligospermic patients with subsequent contralateral testicle cancer transient normospermia was observed after 1 year. After orchiectomy fatherhood was recorded in 28 men and was assisted by fertilization using fresh semen in 2.


CONCLUSIONS
In nonrelapsing testicular cancer cases on surveillance, initially reduced spermatogenesis recovers during year 1 after orchiectomy especially if baseline serum FSH is normal. Transient recovery also occurs in patients in whom contralateral testicular cancer subsequently develops. In high risk patients and in initially oligospermic patients with plans for future fatherhood, the period of improved spermatogenesis may be used for multiple semen cryopreservations enabling subsequent assisted fertilization.
Jacobsen
K D
KD
Department of Medical Oncology and Radiotherapy, Central Laboratory, The Norwegian Radium Hospital, Oslo, Norway.
Theodorsen
L
L
Fossa
S D
SD
D000328:Adult; D005640:Follicle Stimulating Hormone / Q000097:blood; D005500:Follow-Up Studies; D018237:Germinoma / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D009919:Orchiectomy; D013076:Sperm Count; D013091:Spermatogenesis; D013736:Testicular Neoplasms / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors
D005640:Follicle Stimulating Hormone