[Sterility and tumors of the testis. Study of late exocrine and endocrine functions in stage I or IIA tumors].

Spermatogenesis and plasma hormone levels (testosterone, follicle stimulating hormone and 17 beta estradiol) were studied in patients presenting stage I or IIA testicular tumors. Patients with a previous history of cryptorchidism or varicocele, and those who had received combined chemotherapy, were excluded. In 22 patients (10 seminomas and 12 non-seminoma tumors) a spermogram was obtained at the time of orchidectomy, before the procedure in 9 cases and immediately afterwards in 13. Hormone levels, together with tumor marker assay (alpha feto protein and beta HCG) were determined preoperatively. Exocrine and endocrine function were restudied after 3 years of follow up. There was an initial restudied after 3 years of follow up. There was an initial deterioration in spermatogenesis in 17 patients (77.8%) as shown by a sperm count less than 20 million per cm3, an ejaculate volume less than 1.5 cm3 and a motility after one hour of less than 60%. In this group 11 patients had a sperm count of less than 10 million per cm3. Endocrine anomalies discovered included an increase in serum beta HCG levels (7 cases), combined with a decrease in follicle stimulating hormone and an increase in 17 beta estradiol. After 3 years, only 5 of these 17 patients demonstrated fertile sperm (29.4%). The endocrine anomalies tended to regress after orchidectomy. While these endocrine anomalies were always accompanied by hypofertility, their absence was not synonymous with a normal spermogram. Thus the reestablishment of fertile sperm remains unlikely even in early stage testicular tumors.