Prevalence of carcinoma in situ of the testis in 207 oligozoospermic men from infertile couples: prospective study of testicular biopsies

Abstract

Abstract Objective: To investigate the prevalence of carcinoma in situ of the testis in a group of oligozoospermic men from infertile couples. Design: A consecutive group of oligozoospermic men from infertile couples were offered bilateral testicular biopsy. The observed prevalence of carcinoma in situ was compared with the expected prevalence of testicular cancer in a corresponding age matched population of Danish men, assuming all untreated cases of carcinoma in situ progress to tumour stage. This calculation was based on data from the Danish Cancer Registry. Subjects: 207 men aged 18–50 years who had sperm density below 10 million/ml in two samples within the previous 2 years or sperm density below 20 million/ml in two samples within the previous 2 years and a history of cryptorchidism or one or two atrophic testicles (orchidometer volume less than 15 cm 3 ), or both. Interventions: Bilateral testicular biopsies. Main outcome measures: Carcinoma in situ in the biopsy specimen. Results: No case of carcinoma in situ was found among the 207 men. The expected number in a normal age matched population of corresponding size was 0.8. Conclusion: There is no increase in risk of carcinoma in situ of the testis in moderately oligozoospermic men of couples referred because of infertility. Key messages Testicular cancer can be prevented if it is diagnosed at the preinvasive stage of carcinoma in situ Infertile men with atrophic testes were considered as a potential high risk group for testicular neoplasia A prospective study of 207 men from infertile couples did not show any increase in risk of carcinoma in situ of the testis in men with moderate oligozoospermia A high risk of testicular neoplasia in men with very low sperm counts, atrophic testes, and irregular echo pattern on ultrasonography cannot be ruled out