To evaluate fertility and use of reproductive technology of testicular cancer survivors in a multi-institutional, cross-sectional study.
This study recruited testicular cancer survivors who were followed after treatment for testicular cancer at eight high-volume institutions between 2018 and 2019. The participants completed the questionnaires on marital status, fertility and use of reproductive technology.
A total of 567 testicular cancer survivors, with a median age of 43 years, responded to the questionnaire. Chemotherapy was given to 398 survivors, including three cycles of cisplatin-based chemotherapy in 106 patients and four cycles in 147 patients. Among 153 survivors who attempted sperm cryopreservation, 133 (87%) could preserve sperm. Of the 28 survivors whose cryopreserved sperm was used, 17 (61%) fathered children. Of the 72 survivors who fathered children without the use of cryopreserved sperm, 59 (82%) fathered naturally. Whereas 33 (20%) of 169 survivors treated without chemotherapy fathered children without using cryopreserved sperm, 39 (10%) of 398 treated with chemotherapy fathered children (P < 0.05). Furthermore, the paternity rate was 12% and 5% in testicular cancer survivors with three and four cycles of cisplatin-based chemotherapy, respectively (P < 0.05). However, of 121 survivors who wanted to have children, 14 (12%) received counseling about infertility treatment.
Testicular cancer survivors preserving their sperm have a higher paternity rate after chemotherapy, especially after four cycles, than those not using cryopreserved sperm. Physicians who give chemotherapy for testicular cancer need to take particular care not only with respect to recurrence of testicular cancer, but also to post-treatment fertility.
International journal of urology : official journal of the Japanese Urological Association. 2021 Jul 18 [Epub ahead of print]
Shinichi Yamashita, Kenichi Kakimoto, Motohide Uemura, Takeshi Kishida, Koji Kawai, Terukazu Nakamura, Takayuki Goto, Takahiro Osawa, Shigeyuki Yamada, Kazuo Nishimura, Norio Nonomura, Kosuke Kojo, Takumi Shiraishi, Osamu Ukimura, Osamu Ogawa, Nobuo Shinohara, Yoshimi Suzukamo, Akihiro Ito, Yoichi Arai
Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan., Department of Urology, Osaka International Cancer Institute, Osaka, Osaka, Japan., Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan., Department of Urology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan., Department of Urology, University of Tsukuba, Tsukuba, Ibaraki, Japan., Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Kyoto, Japan., Department of Urology, Graduate School of Medicine and Faculty of Medicine, Kyoto University, Kyoto, Kyoto, Japan., Department of Urology, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan., Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.