Radically different: why sperm cryopreservation in men with testicular cancer should be offered prior to radical orchiectomy

Sperm cryopreservation before the onset of oncological treatment is a generally accepted method to preserve fertility in men with cancer that enables couples to embark on assisted reproduction. In 604 patients with testicular cancer, we retrospectively showed that sperm cryopreservation was unsuccessful in one out of six patients because of azoospermia, aspermia or cryptozospermia. In these patients, testicular sperm extraction (TESE) can be an alternative sperm preservation method. TESE can be performed during radical orchiectomy in normal testicular parenchyma adjacent to the testicular tumor or in the contralateral testis. We provide arguments for sperm preservation strategies in patients with testicular cancer before radical orchiectomy.