title: Fertility among testicular cancer survivors: a case-control study in the U.S.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Yale University, New Haven, CT 06520, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Kim
authors.forename: Katherine A
authors.initials: KA
authors.lastname: McGlynn
authors.forename: Ruth
authors.initials: R
authors.lastname: McCorkle
authors.forename: Tongzhang
authors.initials: T
authors.lastname: Zheng
authors.forename: Ralph L
authors.initials: RL
authors.lastname: Erickson
authors.forename: David W
authors.initials: DW
authors.lastname: Niebuhr
authors.forename: Shuangge
authors.initials: S
authors.lastname: Ma
authors.forename: Yaqun
authors.initials: Y
authors.lastname: Zhang
authors.forename: Yana
authors.initials: Y
authors.lastname: Bai
authors.forename: Li
authors.initials: L
authors.lastname: Dai
authors.forename: Barry I
authors.initials: BI
authors.lastname: Graubard
authors.forename: Briseis
authors.initials: B
authors.lastname: Kilfoy
authors.forename: Kathryn Hughes
authors.initials: KH
authors.lastname: Barry
authors.forename: Yawei
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005298:Fertility; D006801:Humans; D007248:Infertility, Male / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000150:complications*; D011788:Quality of Life; D012307:Risk Factors; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*; D011795:Surveys and Questionnaires; D017741:Survivors; D013736:Testicular Neoplasms / Q000150:complications*; D014481:United States / Q000453:epidemiology; D055815:Young Adult