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January 3, 1986

Fertility after testicular cancer therapy?

JAMA. 1986;255(1):15-20. doi:10.1001/jama.1986.03370010017003

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Today surgery, radiotherapy, and/or chemotherapy are saving the lives of many young men with testicular cancer. As life and death issues subside, however, a new worry arises: how will these treatments affect future fertility, particularly when sperm counts are low even before therapy?

Oncologists have long been concerned that radiotherapy or chemotherapy in particular might impair spermatogenesis or testosterone production. Results of small studies have suggested that certain patients may have impaired spermatogenic function even before antineoplastic treatment.

Results of larger studies presented at the International Congress of Andrology in Boston support this. According to Denmark's Jorgen G. Berthelsen, MD, the findings suggest that "in some cases a common genetic or environmental factor is responsible for both the impaired spermatogenesis and the predisposition to the development of cancer."

Information accumulating over the past two decades has indicated that most patients with unilateral testicular cancer have impaired semen quality before radiotherapy