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Background <p>Sperm cryopreservation in patients with testicular germ cell tumours (GCTs) is traditionally performed after orchiectomy. But, some evidence suggests preoperative semen quality to be superior. We aimed to clarify the optimal time-point of cryopreservation.In a retrospective study, semen quality of 163 patients&#xa0;analysed preoperatively was compared with 242 patients analysed shortly after orchiectomy. Descriptive statistical methods with standard tests for comparisons were employed along with stratified analyses regarding the influence of clinical factors.</p> Results <p>All major semen parameters were significantly better in the preoperative group: median ejaculate volume (3 ml preoperatively vs. 2 ml postoperatively); median total sperm count (56.9 x10<sup>6</sup>vs.13 x 10<sup>6</sup>), median progressive motility (40% vs. 25%); azoospermia (4.9% vs. 14.9%). Stratified analysis of subgroups did not reveal significant impact of particular clinical factors on the superiority of preoperative semen quality. Limitations relate to the design of group comparison rather than intraindividual longitudinal comparisons and to selective inclusion of patients opting for cryopreservation.</p> Conclusions <p>In GCT patients, semen quality before orchiectomy is significantly superior to that found immediately after surgery. This superiority encompasses all major semen quality parameters. Of particular note is a threefold increase of azoospermia postoperatively. GCT patients are best advised to have cryopreservation performed before orchiectomy. </p>

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Preoperative semen quality is superior to the quality shortly after orchiectomy in patients with testicular germ cell tumour – a retrospective study from two centres in Germany

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  • 发表日期：

    2025年2月18日

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  • Klaus-Peter Dieckmann,
  • Johanna Hochmuth-Tisch,
  • Andrea Salzbrunn,
  • Cord Matthies,
  • Kathrein von Kopylow,
  • Christian Wülfing,
  • Uwe Pichlmeier,
  • Armin Soave,
  • Christian Guido Ruf

摘要

Background

Sperm cryopreservation in patients with testicular germ cell tumours (GCTs) is traditionally performed after orchiectomy. But, some evidence suggests preoperative semen quality to be superior. We aimed to clarify the optimal time-point of cryopreservation.In a retrospective study, semen quality of 163 patients analysed preoperatively was compared with 242 patients analysed shortly after orchiectomy. Descriptive statistical methods with standard tests for comparisons were employed along with stratified analyses regarding the influence of clinical factors.

Results

All major semen parameters were significantly better in the preoperative group: median ejaculate volume (3 ml preoperatively vs. 2 ml postoperatively); median total sperm count (56.9 x106vs.13 x 106), median progressive motility (40% vs. 25%); azoospermia (4.9% vs. 14.9%). Stratified analysis of subgroups did not reveal significant impact of particular clinical factors on the superiority of preoperative semen quality. Limitations relate to the design of group comparison rather than intraindividual longitudinal comparisons and to selective inclusion of patients opting for cryopreservation.

Conclusions

In GCT patients, semen quality before orchiectomy is significantly superior to that found immediately after surgery. This superiority encompasses all major semen quality parameters. Of particular note is a threefold increase of azoospermia postoperatively. GCT patients are best advised to have cryopreservation performed before orchiectomy.