Recovery of impaired pretreatment spermatogenesis in testicular cancer

Light microscopic sperm analysis was done 24 months after treatment or later in 25 patients with testicular cancer with azoospermia or severe oligospermia (sperm cell count 6 /mL) after orchiectomy before further treatment. Treatment after orchiectomy consisted of abdominal irradiation, cisplatin-based chemotherapy, retroperitoneal surgery, a combination of the former treatment modalities, or a surveillance policy. At the time of post-treatment reassessment, 15 of the 25 patients had sperm cell concentrations of at least 10 × 10 6 /ml (7 of 14 patients in the azoospermia group; 8 of 11 patients in the oligospermia group). Eight patients fathered a child after discontinuation of treatment for testicular cancer. Recovery of spermatogenesis could be seen after all types of treatment. A highly increased pretreatment serum follicle-stimulating hormone was correlated with lack of sperm cell production recovery.