(173) ONCO-TESE DURING ORCHIECTOMY FOR TESTICULAR TUMOR IN PATIENTS WITH AZOOSPERMIA/OLIGOZOOSPERMIA: OUR EXPERIENCE

Abstract Objectives Patients with testicular cancer are at increased risk of infertility or semen quality abnormalities. Due to the high cure rates of testicular tumors (especially germ cell tumors), fertility protection is becoming increasingly important. For this reason it is mandatory to offer sperm cryopreservation prior to treatment. In patients with oligo/azoospermia prior to orchiectomy, other cryopreservation options can be considered. The aim of this paper is to analyze the results of a cohort of patients undergoing Onco-testicular Sperm Extraction (Onco-TESE). Methods A retrospective review of patients undergoing orchiectomy for testicular tumor in the last 5 years was performed. Those in whom sperm cryopreservation was impossible were offered to undergo, in the same procedure, a Sperm retrieval testicular biopsy (Onco-TESE), from the contralateral testicle or from the same testicle (if this was possible or necessary). Results A total of 108 patients underwent radical orchiectomy between 2016 and 2022 in our center. Of these, 67.5% of patients were considered suitable for seminal cryopreservation (due to age, future genomic desires). Of all of them, 11/73 (15.1%) presented azoospermia or severe oligozoospermia. Six patients underwent simultaneous radical orchiectomy and Onco-TESE. Another orchiectomized patient underwent contralateral testicular biopsy after being diagnosed with azoospermia in the cryopreservation attempt prior to chemotherapy. The mean age was 35.7 years. One patient had a diagnosis of Klinefelter's disease (karyotype 47XXY), and another had a childhood history of orchiectomy of unknown cause. Sperm retrieval was achieved in 3 patients (they did not present any previous genetic alteration). Pathological anatomy showed seminoma in 5/7 patients, TGNS in 1/7 and benign Leydig cell tumor in the last one. Conclusions Seminal cryopreservation should always be performed prior to radical orchiectomy because in case it is not valid, the performance of Onco-TESE can be resorted to as an attempt of Sperm retrieval. Conflicts of Interest None of the authors have any conflict of interest.