Is Routine Pre‐treatment Cryopreservation of Semen Worthwhile in the Management of Patients with Testicular Cancer?

Abstract

Post-treatment fertility was evaluated in 147 patients with testicular cancer. All had pretreatment sperm cell analysis following orchiectomy during the years 1979 to 1987. For only 17 patients was the question of future fertility of no importance. Pre-treatment semen cryopreservation was requested by 91 patients, but poor semen parameters made this procedure impossible in 38. Of 99 evaluable patients, 44 had a post-treatment sperm count .gtoreq. 10 .times. 106/ml and 22 of these fathered a child after treatment. Post-treatment fertility was observed to the same degree in patients who had pre-treatment semen cryopreservation as in those in whom this procedure could not be performed. Four of 53 patients used their deep-frozen semen but only 1 pregnancy resulted. The intensity of treatment, especially the extent of retroperitoneal surgery, had a significant effect on post-treatment fertility in the individual patient. Pre-treatment cryopreservation of semen may be psychologically useful in patients with newly diagnosed testicular cancer, but its clinical significance is doubtful.