Paternity often possible after treatment for testicular cancer

New research indicates that an overall paternity rate of 71% can be achieved after treatment for testicular cancer. However, the type of treatment has a strong impact on the rate and how long it will take to conceive.

“The comprehensive data presented in this article should serve as a reliable guide for physicians counseling new or prior testicular cancer patients for whom fertility is of major concern,” lead author Dr. Marianne Brydoy, from Haukeland University Hospital in Bergen, Norway, and colleagues note. The findings, which appear in the Journal of the National Cancer Institute for November 2, are based on a study of 554 long-term survivors of testicular cancer who attempted to conceive following treatment.The subjects were divided into groups based on the treatment received after orchiectomy: surveillance, retroperitoneal lymph node dissection, radiotherapy, low-dose chemotherapy, and high-dose chemotherapy.As noted, the overall 15-year actuarial post-treatment paternity rate was 71% without employing cryopreserved sperm. The highest paternity rate, 92%, was in the surveillance group, while the lowest rate, 48%, was in the high-dose chemotherapy group (p < 0.001). The median time from diagnosis to birth of the first child was 6.6 years, but once again the specific time depended largely on the treatment received. Overall, 22% of couples who attempted conception after treatment used some form of assisted reproductive technology. Treatment type, pretreatment fatherhood, and marital status were all independently linked to post-treatment conception, but the strongest predictor was dry ejaculation, conferring a negative effect. "With recent advances in assisted fertility techniques, more testicular cancer survivors may be helped to father children," the authors write. Still, pretreatment sperm preservation should be offered to patients as it is impossible, at present, to predict with complete certainty which men will be able to conceive following treatment, they conclude.(Source: J Natl Cancer Inst 2005;97:1580-1588: Reuters Health: Oncolink: October 2005.)