Testicular cancer is a rare type of tumor. In fact, it represents only 1-2% of the total cases of childhood cancer and 2% in adult adults. However, it must be said that it is the most common type of cancer in men aged between 15 and 35 years.
An important fact to note is that testicular cancer is one of those with a higher cure rate of 90-95%, so the circumstance that the highest incidence is in young people who have not yet been able to Raising the possibility of having offspring raises the need to preserve the patient’s fertility before starting treatment, for which there are different possibilities:
- Surgery, with the removal of the affected testicle.
- Radiotherapy.
- Chemotherapy.
All of them affect fertility, in a way that can be transitory or definitive. It should not be forgotten that both chemotherapy and radiotherapy affect both cancerous and healthy cells, and that sometimes cancer can affect both testicles, so surgery alone can also generate definitive infertility.
All this means that oncologists presently present to patients the possibility of preserving their fertility, as long as they are not prepubertal, a circumstance that will not give an option for it.
In such cases, a fertility study will have to be done beforehand by performing a seminogram and, depending on each case, performing other seminal quality tests such as the so-called REM, Tunnel and FISH. It should not be forgotten that 3% of patients already have infertility at the time of diagnosis and that some risk factors associated with testicular cancer already cause infertility (due to hypogonadism, feminization of the genital system, etc.). However, it should be noted that some patients recover fertility after one or two years after being definitively discharged after treatment.
The preservation of fertility is done by obtaining semen and its subsequent cryopreservation in authorized semen banks so that they can be used in the future when the patient decides to become a father and wants their children to be their own. For this purpose, three samples will be necessary and the process takes about ten days, since sexual abstinence must be maintained during the two or three days prior to obtaining the sample. In cases where the sample cannot be obtained through masturbation, the testicular semen aspiration technique can be used.
As long as there is no problem of absolute sterility, seminal cryopreservation ensures the possibility of future paternity for patients with testicular cancer, since with the technique of intracytoplasmic injection (ICSI) a sperm is enough to achieve fertilization of the oocyte and for this, the highest quality sperm will be selected using the different techniques currently available.