Male Infertility and the Risk of Developing Testicular Cancer: A Critical Contemporary Literature Review

Abstract

Background and Objectives: The relationship between male infertility (MI) and testicular cancer (TC) is bilateral. On one hand, it is well-established that patients diagnosed with TC have a high risk of pre- and post-treatment infertility. On the other hand, the risk of developing TC in male infertile patients is not clearly defined. The objective of this review is to analyze the histopathological, etiological, and epidemiological associations between MI and the risk of developing testicular cancer. This review aims to provide further insights and offer a guide for assessing the risk factors for TC in infertile men. Materials and Methods: A comprehensive literature search was conducted to identify relevant studies discussing the relationship between MI and the risk of developing TC. Results: The incidence rates of germ cell neoplasia in situ (GCNIS) appear to be high in infertile men, particularly in those with low sperm counts. Most epidemiological studies have found a statistically significant risk of developing TC among infertile men compared to the general or fertile male populations. The concept of Testicular Dysgenesis Syndrome provides an explanatory model for the common etiology of MI, TC, cryptorchidism, and hypospadias. Clinical findings such as a history of cryptorchidism could increase the risk of developing TC in infertile men. Scrotal ultrasound evaluation for testis lesions and microlithiasis is important in infertile men. Sperm analysis parameters can be useful in assessing the risk of TC among infertile men. In the future, sperm and serum microRNAs (miRNAs) may be utilized for the non-invasive early diagnosis of TC and GCNIS in infertile men. Conclusions: MI is indeed a risk factor for developing testicular cancer, as demonstrated by various studies. All infertile men should undergo a risk assessment using clinical examination, ultrasound, and semen parameters to evaluate their risk of TC.

Laparoscopic approach of inguinal hernia associated with adult cryptorchidism: case series and literature review

“…Cryptorchidism is associated with testicular cancer [ 11 ], infertility [ 3 ], inguinal hernia, and testicular torsion [ 2 ]. Interestingly, in rare circumstances, an irreducible hernia can result in cryptorchid testes in the inguinal canal.…”

“…In the first case, surgical treatment consists of corrective surgery (orchidopexy), whereas in second, orchidectomy is the treatment of choice [ 1 , 2 ]. This is due to the increased risk of malignancy in adults and the associated low fertility rate associated [ 3 , 4 ].…”

Unilateral Post-Chemotherapy Robot-Assisted Retroperitoneal Lymph Node Dissection for Stage II Non-Seminomatous Germ Cell Tumors: Sexual and Reproductive Outcomes

“…Nonetheless, due to the high incidence during reproductive age, men with testicular cancer have to deal with fertility issues [ 26 ]. Indeed, on the one hand, previous findings showed that even before their diagnosis, patients with testicular cancer can display an alteration in terms of sperm count and motility, which can be deteriorated by orchidectomy and chemotherapy [ 27 , 28 ]. On the other hand, the multimodal therapeutic approach reserved to these patients can worsen these parameters, with the lowest fertility rates reported in patients treated with combined therapy, thus including men who had undergone PC-rRPLND [ 22 , 29 ].…”

Testicular Cancer Treatments and Sexuality: A Narrative Review

“…Twenty-five to thirty-five percent of the patients show distant metastasis at first presentation [4]; thanks to the combination of surgery, chemotherapy, and radiotherapy, excellent long-term survival rates can be achieved [11,12]. The diagnosis of TC can be achieved thanks to the self-palpation and ultrasonography of the testes, which typically shows a hypoechoic intratesticular lesion or a heterogeneous irregular mass [13,14]. Serum alpha-fetoprotein (AFP), beta subunit of human chorionic gonadotropin (β-hCG), and LDH should be executed before and after orchidectomy as they guide the diagnosis of TC and may be indicative of germ cell tumor histology.…”