https://doi.org/10.4081/aiua.2024.12238

Semen parameters in testicular tumor patients before orchiectomy: What is the impact of testicular tumor stage and histology?

Vol. 96 No. 1 (2024)
Submitted: December 28, 2023
Accepted: December 29, 2023
Published: February 22, 2024
Testicular cancer, male infertility, cryopreservation, sperm parameters, orchiectomy
Abstract Views: 367
PDF: 220
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Authors

Gonçalo Mendes
goncalo.grilomendes@gmail.com
https://orcid.org/0000-0001-5306-1200
Department of Urology, Santo António University Hospital Center, Porto, Portugal.
Bernardo Teixeira
https://orcid.org/0000-0001-8582-6618
Department of Urology, Santo António University Hospital Center, Porto, Portugal.
Mariana Madanelo
https://orcid.org/0000-0001-8429-7785
Department of Urology, Santo António University Hospital Center, Porto, Portugal.
Alexandra Rocha
https://orcid.org/0000-0002-5841-8966
Department of Urology, Santo António University Hospital Center, Porto, Portugal.
Sofia Mesquita
Department of Urology, Santo António University Hospital Center, Porto, Portugal.
João Vital
https://orcid.org/0009-0000-6252-5142
Department of Urology, Hospital of Funchal, Portugal.
Miguel Monteiro
https://orcid.org/0000-0002-8222-0511
Department of Urology, Santo António University Hospital Center, Porto, Portugal.
Avelino Fraga
Department of Urology, Santo António University Hospital Center, Porto, Portugal.
Nuno Louro
https://orcid.org/0000-0003-3795-7300
Department of Urology, Santo António University Hospital Center, Porto, Portugal.

Purpose: To evaluate the influence of testicular cancer histology and stage on sperm parameters in cryopreserved samples collected prior to orchiectomy.
Materials and methods: We conducted a retrospective analysis of tumor histology, stage and sperm parameters of patients who underwent pre-orchiectomy sperm cryopreservation for testicular cancer between March 2010 and March 2023. The World Health Organization (WHO) 2010 sperm reference values were used to identify patients with subnormal semen parameters and to further categorize patients by sperm alteration. Localized disease was classified as Stage I, while metastatic disease encompassed Stages II and III. Continuous variables were compared using t-test or Mann Whitney U test, and categorical variables using Chi-square and Fishers exact test.
Results: A total of 64 patients was identified, 48 (75%) classified as stage I and 16 (25%) classified as stage II/III. No difference was found in semen parameters between patients with seminoma and patients with non-seminoma germ cell tumor (NSGCT). Patients with stage II/III disease had significantly lower percentages of progressive motility (36% vs 53%, p=0.021) and total motility (60% vs 69%, p=0.015) than stage I patients. When categorizing by sperm alterations according to WHO 2010 reference values, patients with stage II/III disease had significantly higher proportions of asthenozoospermia (38% vs 15%, p=0.048) and teratozoospermia (63% vs 31%, p=0.027) than stage I patients. Elevated tumor markers were not associated with sperm abnormalities.
Conclusions: Patients with metastatic testicular cancer present with worse sperm quality than patients with localized disease. Sperm cryopreservation should be offered to all patients with testicular cancer, and especially emphasized in patients with metastatic disease.

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How to Cite

Mendes, G., Teixeira, B., Madanelo, M., Rocha, A., Mesquita, S., Vital, J., Monteiro, M., Fraga, A., & Louro, N. (2024). Semen parameters in testicular tumor patients before orchiectomy: What is the impact of testicular tumor stage and histology?. Archivio Italiano Di Urologia E Andrologia, 96(1). https://doi.org/10.4081/aiua.2024.12238
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