Is routine pre-treatment cryopreservation of semen worthwhile in the management of patients with testicular cancer?

Post-treatment fertility was evaluated in 147 patients with testicular cancer, All had pre-treatment sperm cell analysis following orchiectomy during the years 1979 to 1987. For only 17 patients was the question of future fertility of no importance. Pre-treatment semen cryopreservation was requested by 91 patients, but poor semen parameters made this procedure impossible in 38. Of 99 evaluable patients, 44 had a post-treatment sperm count greater than or equal to 10 x 10(6)/ml and 22 of these fathered a child after treatment. Post-treatment fertility was observed to the same degree in patients who had pre-treatment semen cryopreservation as in those in whom this procedure could not be performed. Four of 53 patients used their deep-frozen semen but only 1 pregnancy resulted. The intensity of treatment, especially the extent of retroperitoneal surgery, had a significant effect on post-treatment fertility in the individual patient. Pre-treatment cryopreservation of semen may be psychologically useful in patients with newly diagnosed testicular cancer, but its clinical significance is doubtful.