Fertility and Hormonal Function in Patients with a Nonseminomatous Tumor of the Testis

Abstract

Semen quality and serum testosterone, LH, and FSH levels were studied in 54 patients with a unilateral nonseminomatous tumor of the testis-14 before and 40 after orchiectomy.

Semen analyses before and after orchiectomy gave essentially no different results: a poor semen quality was found in most men. The additional effect of a recent orchiectomy on semen quality was not demonstrable in the patients described here.

Before orchiectomy, increased testosterone levels were found in patients with a β-hCG-producing tumor. After orchiectomy serum testosterone levels were decreased, and LH and FSH levels increased. With β-hCG-producing tumors FSH was suppressed after orchiectomy, and testosterone levels did not exceed those in patients with a tumor not producing β-hCG.

The results of semen analysis and of hormonal studies after orchiectomy suggest a dysfunction of the remaining “normal” testis. Diminished spermatogenesis and insufficient testosterone production by the Leydig cells clearly indicate anomalies already present before orchiectomy.

Key Words:

• Gonadal function
• Nonseminomatous testis tumor