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Human Reproduction, Vol. 16, No. 11, 2343-2346, November 2001
© 2001 European Society of Human Reproduction and Embryology

Testicular sperm extraction in a patient with metachronous bilateral testicular cancer

Case report

F-M. Köhn1,5, I. Schroeder-Printzen2, W. Weidner2, M. Montag3, H. van der Ven3 and W-B. Schill4

1 Department of Dermatology and Allergology, Technical University, Munich, 2 Clinic of Urology, Justus Liebig University, Giessen, 3 Department of Gynaecological Endocrinology and Reproductive Medicine, Rheinische Friedrich Wilhelms University, Bonn and 4 Centre of Dermatology and Andrology, Justus Liebig University, Giessen, Germany

A new indication for testicular tissue cryopreservation is demonstrated in a patient with metachronous bilateral testicular tumours and azoospermia. At the age of 18 (1982) the patient underwent left orchidectomy and radical retroperitoneal lymphadenectomy for a testicular teratoma (pT1N0M0). Semen samples were not cryopreserved because of absence of motile spermatozoa after thawing. Seventeen years after the primary testicular cancer, a seminoma of the contralateral right testis was diagnosed (pT1N0M0). Since the patient was azoospermic, no semen samples could be cryopreserved. However, spermatozoa were detected in testicular biopsy material of the right testis and were cryopreserved for ICSI. Since all spermatozoa were dead after thawing, testicular sperm extraction (TESE) was performed in the remaining tissue samples at the time of ICSI treatment. Only spermatids could be extracted from frozen–thawed samples due to the inhomogeneous distribution of spermatogenic activity in the testicular tissue. Although one oocyte was fertilized with these spermatids, a clinical pregnancy was not achieved. Despite the disappointing results of ICSI in the couple presented here, this case report demonstrates that cryopreservation of testicular tissue and TESE should be considered in patients with bilateral testicular tumours and azoospermia, if frozen semen samples are not available.

Key words: azoospermia/seminoma/teratoma/TESE/testicular cancer

5 To whom correspondence should be addressed at: Department of Dermatology and Allergology, Technical University, Biedersteiner Str. 29, 80802 Munich, Germany. E-mail: Frank.Koehn{at}lrz.tu-muenchen.de


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