Predictors of Spermatogenesis in Orchiectomy Specimens

Predictors of spermatogenesis in radical orchiectomy specimen and potential implications for patients with testicular cancer

“…The overall rate of spermatogenesis in our study was 68%, comparable with the reports by Delouya et al (20) and Choy et al (21), who found rates of 79% and 62%, respectively. Hence, sperm can be found in the resected testicle of most patients with TC, and can potentially be extracted during orchiectomy.…”

“…Consequently, although the results of Delouya et al (20) imply a systemic effect of testis cancer on spermatogenesis, our findings suggest that local tumor burden impacts the most. The inverse relation between tumor size and the occurrence of spermatogenesis has been previously described (20,21); however, even in the presence of very large tumors (10 cm), we were able to identify spermatozoa in the rim of testicular parenchyma. In addition, we found mature spermatozoa in the pathological specimens of 68.7% (11/16 patients) with a preorchiectomy diagnosis and evaluation of primary infertility.…”

“…Only few studies, with a limited number of patients, have evaluated possible predictors of complete spermatogenesis in the cancerous testis. Two studies (20,21) highlighted the need to examine the correlation between semen analysis and the presence of mature spermatozoa in the resected testicle.…”

Infertility with Testicular Cancer

“…There was a statistically significant inverse relationship between tumor size and spermatogenesis presence; however, a larger tumor size did not preclude the presence of spermatogenesis. 49 Published success rates are up to 40% to 60% for onco-TESE, but it is difficult to generalize due to the low number of patients. [49][50][51] Also, some surgeons argue that patients with nonobstructive azoospermia should be treated with a microsurgical (micro)-TESE on the side of the testicular tumor.…”

“…49 Published success rates are up to 40% to 60% for onco-TESE, but it is difficult to generalize due to the low number of patients. [49][50][51] Also, some surgeons argue that patients with nonobstructive azoospermia should be treated with a microsurgical (micro)-TESE on the side of the testicular tumor. They also recommend having a discussion about a contralateral micro-TESE at the time of orchiectomy.…”