title: Fertility in patients treated for testicular cancer.
abstract: BACKGROUND
  Testicular cancer affects men mostly in their reproductive age with a cure rate over 90% and fertility is one of the main concerns of survivors. To further elucidate the question of fertility after treatment for testicular cancer, we performed a survey in patients treated in our institution.
  
  
  METHODS
  We sent a questionnaire to patients treated for testicular cancer at our institute from 1976 to 2002 (n = 490) of whom 297 (60.6%) responded. We considered the patients to have conserved fertility if they had children after treatment without assisted reproductive technologies.
  
  
  RESULTS
  Before treatment 119/297 (40.1%) of patients and after treatment 150/297 (50.5%) of patients tried to have children (p = 0.019). Of 119 patients who tried to have children before treatment for testicular cancer 98 (82.4%) succeeded and 74/150 (49.3%) were successful after treatment (p < 0.001). After treatment patients had 1-3 (median 1) children. The median time to birth of first child from diagnosis was 12 years. The post-treatment fatherhood in patients treated with surgery only (orchidectomy +/- retroperitoneal lymphnode dissection-RPLND) was 59%, in those with additional radiotherapy 68%, and chemotherapy 50% (p = 0.233). Fertility rate in patients where a non nerve sparing RPLND was performed was only 37%, 62% in patients with nerve sapring RPLND, and 77% in patients where RPLND was not performed (p < 0.0001).
  
  
  CONCLUSIONS
  Fertility rate after treatment for testicular cancer is reduced. From our data, the most important treatment modality that influences fertility is non nerve sparing RPLND that should be avoided whenever possible in order improve the quality of life our patients.
authors.affiliation: Department for Medical Oncology, Institute of Oncology Ljubljana, Slovenia. ematos@onko-i.si
authors.forename: Erika
authors.initials: E
authors.lastname: Matos
authors.forename: Breda
authors.initials: B
authors.lastname: Skrbinc
authors.forename: Branko
authors.initials: B
authors.lastname: Zakotnik
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005298:Fertility; D006801:Humans; D007248:Infertility, Male / Q000209:etiology*; D008197:Lymph Node Excision / Q000009:adverse effects*; D008297:Male; D009919:Orchiectomy / Q000009:adverse effects; D011788:Quality of Life; D011878:Radiotherapy; D012187:Retroperitoneal Space; D012307:Risk Factors; D018239:Seminoma / Q000150:complications / Q000628:therapy; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*; D011795:Surveys and Questionnaires; D017741:Survivors; D013736:Testicular Neoplasms / Q000150:complications / Q000628:therapy*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents