Introduction
Patients with TGCT (testicular germ cell tumor) have the highest
prevalence among men aged 15 to 35 years, accounting for 1.0% to 1.5%
of male neoplasms.1 The incidence of the testicular
dysgenesis syndrome (TDS) (decreased spermatogenesis, hypospadias,
cryptorchidism, testicular tumors) in men has increased in recent
decades, and four events are often interrelated.2Patients with TGCT are more likely to cure, although post-operative
chemotherapy and/or radiotherapy damage the rest of healthy testis,
resulting in infertility. Several papers have pointed out that
testicular tumors and treatments cause male infertility and recommend
cryopreservation of sperm before treatment.3-5Infertility becomes the mental damage for a young patient. Most of these
young patients will not know that treatment of cancer may make them
infertility at the time of diagnosis, and they will not have plans to
have children. For patients, the knowledge that germ cells were
cryopreserved prior to the start of treatment, whether or not they were
used as a means of assisted reproductive therapy, enhances the patient’s
quality of life and comfort.6 More than 50% of
patients with cured testicular tumors want a child after treatment, and
75% have no children at the time of diagnosis.7 The
American Society of Clinical Oncology recommends sperm cryopreservation
for fertility preservation, but few patients receive infertility
treatment.8 Of the patients, only 51% participated in
the sperm bank and only 24% actually had their sperm cryopreserved,
according to findings from two major cancer centers.9Patients with TGCTs have cure rate of 80% to more than 90% by
combining surgery, radiation, and chemotherapy based on diagnosis and
staging, and the trend is currently upward.10 After
treatment, strict follow-up and salvage therapy help maintain good cure
rate.11-13 Testicular sperm extraction (TESE) may be
performed to retain fertility in patients with TGCTs and azoospermia.
We describe congenital single testis patient with testicular cancer and
azoospermia who was underwent ipsilateral Onco-TESE during radical
orchiectomy and succeeded in sperm
collection,
followed by having a healthy child
after intracytoplasmic sperm
injection (ICSI).