P-410 Alterations in semen quality following treatment for testicular cancer: Insights from a retrospective analysis

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Abstract Study question Is there any alteration in semen quality among patients underwent treatment for testicular cancer ? Summary answer No change was observed in sperm parameters in most testicular cancers with a non-statistical increased in azoospermia from 2.7% to 5.6%) What is known already Testicular cancer is the most prevalent malignancy among young men, with approximately 2,400 new cases diagnosed annually in the UK, accounting for 1% of all male cancer cases (1). The average age at diagnosis is around 33 years (2). Studies have documented significant alterations in semen parameters following anticancer treatments. While some men show recovery over time, the extent of recovery is influenced by the type and dose of treatment, with recovery observed in approximately 50% of patients(3,4). Interestingly, one study found that sperm quality was unaffected by one course of chemotherapy for early testicular cancer (5). Study design, size, duration This retrospective study analysed sperm quality in patients diagnosed with testicular tumors who were referred for fertility preservation between 2000 and 2023. After excluding records with unidentifiable data, irrelevant conditions, recurrence disease and sample collection intervals of less than one year, 233 patients were identified. Semen analysis was performed before cryopreservation and at least one year after the initial collection, the result interpretation was carried out using the 2010 World Health Organization (WHO) Laboratory Manual. Participants/materials, setting, methods Demographic data and treatment details were extracted from electronic medical records. Semen quality was assessed pre- and post-treatment, with parameters such as sperm count, and motility analysed. Descriptive statistics summarised the data, and statistical analysis included chi-square test and paired T- tests to evaluate changes in semen parameters, with significance set at p < 0.05. Subgroup analyses considered seminoma, non-seminoma, and absent histological diagnosis. Treatments considered chemotherapy alone, surgical treatment alone, vs surgical treatment combined with chemotherapy. Main results and the role of chance The age range of patients was (16-47) with median age of 38 years. The diagnoses were seminoma,24.5% ( 58/233), non-seminoma 37.8% ( 88/233), and absent histological diagnosis 37.3% (87/233). The treatments received were chemotherapy (Bleomycin, etoposide and platinum or carboplatin) alone 6.4% (15/233), surgical treatment (excision or orchidectomy with or without lymph node dissection) 28.3% (66/233), surgical treatment and chemotherapy 62.2% (145/233), radiotherapy 2%( 5/233) and surgical treatment with targeted therapy 0.8% (2/233). We looked at motility and sperm count in specific. Asthenospermia was observed in 57.5% of samples with 50.7% oligospermia; six patient (2.7%) had azoospermia and 43.3% had severe or moderate oligozoospermia at the time of referral. No significant change was observed after treatment. After anti-cancer treatment, asthenospermia was observed in 48.9% (P = 0.0634); 13 patients (5.6%), ( P = 1.289) had azoospermia and 45.5% had severe of moderate oligozoospermia (P = 0.06) . The median sperm count was 14.4 million, with a reduction of 2.693million in mean cell count for patient who underwent anti-cancer treatment ( P = 0.3346; 95% CI -2.47to 7.24). Limitations, reasons for caution This study’s retrospective design may introduce bias due to incomplete data and reliance on available sperm samples, potentially not reflecting the broader patient population. The impact of other factors, such as treatment intensity, and lifestyle factors were not fully explored. Small subgroup sizes limit generalisability, requiring further prospective studies. Wider implications of the findings The study highlights the potential of no alteration in semen quality after undergoing anti-cancer treatment in testicular cancer patients. These findings inform fertility preservation decisions but also stress the need for further research to understand the long-term effects of individual treatment types, and other influencing health factors. Trial registration number No

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