A review of testicular intratubular germ cell neoplasia in infertile men.

A group of 2,739 infertile men whose testes were biopsied during the investigation of infertility in the period from January 1955 to December 1992 have been reviewed. Unilateral intratubular germ cell neoplasia was seen in the testicular biopsies of 16 patients and was always associated with testicular atrophy (Johnsen score lower than 4). Germ cell tumors of the testis occurred in 50% of untreated patients within 6 years and the longest period of tumor-free follow-up was 10 years. A retrospective study was performed to evaluate the incidence of tumors in a subset of 1,639 infertile men biopsied between 1955 and 1982. Three of the patients, without intratubular germ cell neoplasia on the biopsy, were found to have developed a germ cell tumor. The incidence and management of intratubular germ cell neoplasia in infertile men is discussed.