BERKELEY, CA (UroToday.com) - The lower fertility potential of patients diagnosed with testicular cancer is well established. While obvious reasons include the impact of orchiectomy and/or chemotherapy on semen parameters, some have suggested that these patients possess an inherent dysfunction in spermatogenesis which may be bilateral. The exact risk of testicular cancer in a patient with primary infertility is poorly defined.

Raman, Nobert, and Goldstein from the Department of Urology of Cornell University reviewed the records of over 3,800 patients who presented with male infertility and abnormal semen analyses over a period of 10 years. The risk of developing testicular cancer was assessed and compared with population data from matched controls obtained from the Surveillance, Epidemiology and End Results (SEER) database.

Of 3,847 men with infertility and abnormal semen parameters, 10 (0.3%) were diagnosed with testicular tumors at a mean patient age of 32.6 years. All 10 men were diagnosed with seminomas. Interestingly, only 8 of the 10 men reported a history of cryptorchidism.

Although retrospective, this valuable study in a large group of patients suggests that infertile men with abnormal semen parameters have a 20-fold higher incidence of testicular cancer even in the absence of a history of undescended testes.

J Urol. 2005 Nov;174(5):1819-22