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Hum. Reprod. Advance Access published online on December 15, 2006
Human Reproduction, doi:10.1093/humrep/del468
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Testicular sperm extraction in cancerous testicle in patients with azoospermia: A Case Report

Luca Carmignani1,4, Franco Gadda1, Giacomo Gazzano2, Guido Ragni3, Alessio Paffoni3, Francesco Rocco1 and Giovanni Maria Colpi3

1 Urology Unit 2 Pathology Unit 3 Andrology Unit, Fondazione IRCCS Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, San Paolo Hospital, University of Milan, Milan, Italy

4 To whom correspondence should be addressed at: Department of Medicine and Surgery. Urology Unit, Fondazione IRCCS Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, San Paolo Hospital, University of Milan, Via Luigi Sacco 7, Milan 20146, Italy. E-mail: luca.carmignani{at}unimi.it

The aim of this study is to evaluate the feasibility of testicular sperm extraction (TESE) in a cancerous testicle during orchiectomy for testicular neoplasm. This is a retrospective study and includes case histories of four azoospermic patients with incidental testicular cancer. None of the patients had fathered children prior to surgery and all patients were strongly motivated by the desire to have offspring. Patients underwent surgical exploration via inguinotomy and spermatic cord clamping. After nodule excision, micro-TESE was performed from the same albugineal incision, under microscopic guidance. Frozen section examination was not performed in the case of large nodules (>3 cm in diameter). Two patients showed classic seminoma and underwent orchiectomy. In two patients, a Leydig cell tumour was found (one patient underwent orchiectomy for large nodule size). Micro-TESE was performed in four patients. Spermatozoa were found in three patients and the retrieved sperm was cryopreserved. One ICSI cycle was performed, but pregnancy failed. In azoospermic patients with testicular nodules, TESE in the cancerous testis is feasible and may avoid further surgery, without any oncological risk.

Key words: azoospermia/infertility/testicular cancer/testicular sperm extraction


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