P-372 Reproductive ability in survivors of childhood, adolescent, and young adult testicular tumors
Authors: Liu X 
Published: July 2024

Abstract

Study question
There is little comprehensive fertility evaluation in testicular tumors.

Summary answer
Our study provides evidence that sexual dysfunction and infertility represent the major persisting side effects with testicular tumor patients.

What is known already
Testicular cancer, although accounting for 1% of all cancers, is the most common cancer in men of reproductive potential with a peak incidence in men between the ages of 15-35, with more than 95% of the patients being cured.There are many researches on semen quality in testicular cancer.

Study design, size, duration
We performed a retrospective study by collecting 126 records of testicular cancer patients who attempted sperm banking in the Human Sperm Bank, West China Second University Hospital, Sichuan University between 2011 and 2022.

Participants/materials, setting, methods
Semen samples were collected by masturbation after 2–7 days of sexual abstinence. While a few of the patients had a longer period of sexual abstinence than one week, due to emergency treatment (data not shown). All samples were allowed to liquefy at 37 °C for 60 min and were then assessed according to World Health Organization protocols (WHO, 1999, 2010).

Main results and the role of chance
Semen quality and hormone levels before chemotherapy/radiotherapy
In our study, we compare semen samples before and after orchiectomy, no differences in semen analysis were observed between pre-and post-orchiectomy groups.
Semen quality after cancer treatment: type of treatment
Total sperm number worsened significantly at T3(T6, 6 months after the end of treatment), T6 compared to baseline (T0, before beginning cancer treatment) and returned to near-baseline values at T24 in Carboplatin 2 cycles and EP/BEP 2-4 cycles groups. Moreover, Serum LH and FSH was increased at T3, T6 compared at T0.
Sexual Functioning
The BFSI (Brief Male Sexual Function Inventory) is a validated self-report measure of sexual functioning. We compared BSFI scores before and after orchiectomy, no differences were observed in sexual drive, sexual erection, sexual ejaculation, DEE (drive, erection, ejaculation) problems and sexual satisfaction between pre-and post-orchiectomy groups. Chemotherapy/radiation group significantly fewer sexual satisfaction problems compared with untreatment/surgery group.
Fertility outcome
Fertility data were available for 88 patients. 65 (73.9%) had no children, for various reasons (young age, financial reasons, marital status), 6 (6.8%) already had at least one child prior to their cancer diagnosis. Seventeen patients (19.3%) wanted children, but only 11 of these succeeded in achieving fatherhood, through natural fertility (8 patients) or ART (3 patients).

Limitations, reasons for caution
Small sample size, and the follow-up was not long enough.

Wider implications of the findings
We analyzed semen parameters, hormone levels, sexual functioning, fertility outcome for testicular cancer patient, both before diagnosis and after treatment, with the aim to provide practical recommendations.

Trial registration number
not applicable’