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Fertility among testicular cancer survivors: a case-control study in the U.S.

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Abstract

Introduction

Testicular germ cell tumors (TGCT) disproportionately affect men between the ages of 15 and 49 years, when reproduction is typical. Although TGCT treatment directly affects gonadal tissues, it remains unclear whether there are long-term effects on fertility.

Methods

To examine post-TGCT treatment fertility, study participants in a previously conducted case-control study were contacted. The men were initially enrolled in the US Servicemen’s Testicular Tumor Environmental and Endocrine Determinants (STEED) study between 2002 and 2005. A total of 246 TGCT cases and 236 controls participated in the current study and completed a self-administered questionnaire in 2008–2009.

Results

TGCT cases were significantly more likely than controls to experience fertility distress (OR 5.23; 95% CI 1.99–13.76) and difficulty in fathering children (OR 6.41; 2.72–15.13). Cases were also more likely to be tested for infertility (OR 3.65; 95% CI 1.55–8.59). Cases, however, did not differ from controls in actually fathering children (OR 1.37; 95% CI 0.88–2.15). These findings were predominantly observed among nonseminoma cases and cases treated with surgery only or surgery-plus-chemotherapy.

Discussion

While expressing greater fertility distress, higher likelihood of fertility testing, and difficulty fathering children, these data suggest that TGCT survivors are no less likely to father children than are other men. It is possible that treatment for TGCT does not permanently affect fertility or, alternatively, that TGCT survivors attempt to father children with greater persistence or at younger ages than do other men.

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Acknowledgments

This study is supported by grant CA130110 from the National Cancer Institute (NCI) and by Fogarty training grants 1D43TW008323-01 and 1D43TW007864-01 from the National Institute of Health (NIH). This publication was made possible by CTSA Grant number UL1 RR024139 from the National Center for Research Resources (NCRR), a component of the NIH and NHL roadmap for medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR. The authors are greatly indebted to the Study participants, without whom, there would have been no study. The opinions or assertions contained herein are the private views of the author, and are not to be construed as official, or as reflecting true views of the Department of the Army or the Department of Defense.

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Authors and Affiliations

  1. Yale School of Public Health, Yale University, 60 College Street, LEPH 440, New Haven, CT, 06520, USA

    Christopher Kim, Shuangge Ma, Yaqun Zhang, Yana Bai, Li Dai, Kathryn Hughes Barry & Yawei Zhang

  2. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD, USA

    Katherine A. McGlynn, Tongzhang Zheng, Barry I. Graubard, Briseis Kilfoy & Kathryn Hughes Barry

  3. Yale School of Nursing, Yale University, New Haven, CT, USA

    Ruth McCorkle

  4. Walter Reed Army Institute of Research, Forest Glen, MD, USA

    Ralph L. Erickson & David W. Niebuhr

  5. Gansu Provincial Design and Research Institute of Environmental Science, Lanzhou, Gansu, China

    Yaqun Zhang

  6. Department of Epidemiology and Biostatistics, Lanzhou University School of Public Health, Lanzhou, China

    Yana Bai

  7. National Center for Birth Defect Monitoring, West China Second University Hospital, Sichuan University, Chengdu, China

    Li Dai

Authors
  1. Christopher Kim
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  2. Katherine A. McGlynn
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  3. Ruth McCorkle
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  4. Tongzhang Zheng
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  5. Ralph L. Erickson
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  6. David W. Niebuhr
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  7. Shuangge Ma
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  8. Yaqun Zhang
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  9. Yana Bai
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  10. Li Dai
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  11. Barry I. Graubard
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  12. Briseis Kilfoy
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  13. Kathryn Hughes Barry
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  14. Yawei Zhang
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Corresponding author

Correspondence to Yawei Zhang.

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Kim, C., McGlynn, K.A., McCorkle, R. et al. Fertility among testicular cancer survivors: a case-control study in the U.S.. J Cancer Surviv 4, 266–273 (2010). https://doi.org/10.1007/s11764-010-0134-x

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  • DOI: https://doi.org/10.1007/s11764-010-0134-x

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