PD34-10 PREDICTORS OF SUCCESS FOR ONCO-TESE IN TESTIS CONTAINING TUMOUR AT TIME OF RADICAL ORCHIECTOMY IN AZOOSPERMIC MEN

Abstract

INTRODUCTION AND OBJECTIVES: The prevalance of azoospermia at the time of diagnosis for testicular cancer is between 6-24%. Onco-TESE is an option to preserve and treat fertility in these men at the time of their orchiectomy. Tumor size has been found to predict spermatogenesis on pathology after radical orchiectomy. However, no predictors of success have been documented for onco-TESE. We aim to understand potential predictors of its success in order to inform patients and healthcare professionals about future paternity. METHOD(S): A retrospective analysis of onco-TESE procedures conducted between 2015-2018 at Guys Hospital, London, was undertaken (16 patients and 20 testes). Of the 20 tumours present there were 12 seminomas, 3 mixed germ cell tumours, 3 burned out lesions, one leydig cell tumour and 1 metastasis. 13/20 testis contained ITGCN. Onco-TESE was carried out only ipsilateral to the tumour. RESULT(S): Spermatogenesis was found in 13/20 testes (65%). The mean age at the time of surgery was 34 years (range 25-43). 9/16 patients suffered from bilateral testicular cancer (synchronous or metachronous). OncoTESE success was not associated with size of testis (p=0.82), size of opposite testis (p=0.80), tumor size (p=0.23), the percent of testis (by volume) occupied by tumor (p=0.24), preoperative testosterone (p=0.62), FSH (p=0.31) or LH (p=0.79) levels. To date, 5 couples have attempted IVF. One patient used oncoTESE sperm for two cycles of unsuccessful ICSI. 4 pregnancies have been achieved and 3 children have been born to date by all IVF means. CONCLUSION(S): Onco-TESE is a successful treatment option for the infertile, azoospermic testicular cancer patient. We were unable to identify any predictors of success for Onco-TESE.