Objective: To examine whether infertile men with poor semen count subsequently developed testicular cancers and to describe their clinical presentation.
Design: We reviewed 460 male patients with abnormal semen counts between 1989 and 2004.
Setting: University hospital.
Patient(s): Infertile men who developed testicular cancers after assisted reproductive technologies (ART).
Intervention(s): Description of patient characteristics: age at infertility, presentation, semen quality, and ART.
Main outcome measure(s): The number of patients who subsequently developed testicular cancers and the period from ART to the development of clinical testicular cancers.
Result(s): Of the 460 patients, 169 patients presented with mild oligozoospermia, 117 patients with severe oligozoospermia, and 174 patients with azoospermia. The follow-up periods were as follows: 1-192 months (median, 96.5 mo) for mild oligozoospermia, 1-156 months (median, 78.5 mo) for severe oligozoospermia, and 1-197 months (median, 99 mo) for azoospermia. We subsequently found three testicular cancers that had developed among severely oligozoospermic and azoospermic patients. The period from the claim of sterility to developing testicular cancers varied from 4 to 14 years (median, 9 y).
Conclusion(s): These results indicate that severe semen abnormality may be a risk factor in developing testicular cancers. Self-examination of the testes could be used as an alternative or supplement to physical examination and testicular ultrasound as part of the infertility workup, even after ART.