Discussion
In this patient case, onco-TESE was the last chance to preserve
fertility, because he had been diagnosed with azoospermia. It has been
previously reported that testicular tumor is associated with decreased
spermatogenic ability, and the sperm concentration in testicular tumor
patients was about 1/3 that of general males and the total sperm count
was about 1/6.14 Most
spermatogenesis was affected after
the chemotherapy, and there was the report that spermatogenesis
recovered in 75% of patients 18 months later, but it was clear to lose
of fertility after orchiectomy because he was congenital single
testicular patient.15 According to literature
statistics, the frequency of diagnosed congenital single testis during
surgery for cryptorchidism in Europe and the United States is
4%.16 Assisted reproductive technology has advanced
in recent years, allowing infertile patients to achieve fertilization by
using cryopreserved
sperm.17,18 Papers from several groups of
investigators6,19-21 have been reported that Onco-TESE
is possible in patients with azoospermia and testicular cancer followed
by the use of assisted reproduction to birth of healthy baby by
cryopreserved sperm, but in each case there were no reports of
congenital single testis with
testicular cancer patient. This case shows that Onco-TESE can be done in
patients with congenital single testis such as TDS syndrome. It is
important to operate as many people as possible with Onco-TESE.