Azoospermia and spermatogenesis in testicular cancer

A correlation between infertility and testicular cancer is described by many authors. Studies show that testicular carcinoma in situ and spermatogonial differentiation share histological similarities. According to some authors, male infertility and testicular cancer, together with hypospadias and undescended testis, are linked by a dysgenesis syndrome (the so-called testicular dysgenesis syndrome). Endocrine disrupters and genetic and environmental factors seem to be possible causes. Moreover, diagnosis of testicular cancer is frequently made during male infertility evaluation. Cryopreservation of sperm is the first choice for preservation of fertility before treatment of testis cancer. In cases of azoospermic patients with testicular cancer, when sperm cryopreservation is not possible the only remaining option is testicular sperm extraction, even in cancerous testis during orchiectomy. Recent studies have showed the feasibility of the procedure. The authors will review such topics.