Men with testicular cancer stand a good chance of having children

​A new study from Rigshospitalet shows that men with testicular cancer have a far better chance of obtaining fatherhood after treatment than previously assumed. In fact, statistically around half of all men who have undergone treatment for testicular cancer have the same chance of obtaining fatherhood as the rest of the male population.

A new study from Rigshospitalet's Department of Oncology is good news for men who have or have had testicular cancer. The study shows that men being treated for testicular cancer have a much better chance of obtaining fatherhood than previously assumed.

In fact, the study shows that, based on a foreign study, it has been previously assumed that men have up to a 30% reduced chance of having children after treatment for testicular cancer. However, in reality there is only a 10% reduced chance. And in connection with the least invasive treatment option, there is no statistical difference compared with healthy men.

"This is good news. Because men who get testicular cancer are on average only 30 years old, and they have more than a 95% chance of surviving the disease. So, it can be expected that many of these men have or will have a desire to have children," says Mikkel Bandak, MD, who is behind the study, which was carried out in collaboration with researchers from the Danish Cancer Society.

A unique opportunity

The study has followed almost 5,000 men who have been treated for testicular cancer. These men were compared with a control group with ten times as many participants. For each cancer-treated man, ten men with the same year of birth were selected, and researchers looked at how many of these had obtained fatherhood during a 20-year follow-up period.

"This was only possible due to the Danish registers. By extracting various data from the birth register and the IVF register (assisted reproduction), we had a unique opportunity to carry out this particular type of study in Denmark. And this has also attracted attention from abroad. Until now, we could only rely on an older Norwegian study, when reporting about the chances of having children after treatment. But now we have data that is more valid, more recent and even tells a more positive story," said Mikkel Bandak.

The Norwegian study mentioned above dates back to 2000, and according to Mikkel Bandak, the positive trend is probably linked to several factors: In Denmark we are really good at treating testicular cancer with the least invasive treatment. And the possibilities to obtain assisted reproduction, i.e. IVF treatment, have become much better.

"One thing that probably also matters is that there is easy and free access to fertility treatment in Denmark, and that all patients have the opportunity to deposit sperm before cancer treatment begins", he added.

Less invasive procedure – bigger chance

The study divided the men into groups, depending on the type of cancer treatment they had received. And the overall picture is clear: The less invasive the procedure is, the bigger the chances are of obtaining fatherhood later in life.

"In fact, we see no statistical difference between cancer-treated men and healthy men when only the sick testicle is removed, and this is the treatment that about half of all men with testicular cancer receive. If chemotherapy is subsequently needed, there is a 13% smaller chance of obtaining fatherhood. And this figure will increase to 26% if the cancer has spread and there is a need for both chemotherapy and a more invasive surgical procedure," said Mikkel Bandak and he continued:

"For all groups of men who have been treated for testicular cancer, there is a greater need for IVF treatment than for healthy men. But overall, the group of men who have been treated for testicular cancer only has about a 10% smaller chance of obtaining fatherhood.

The study from Rigshospitalet's Department of Oncology was published in the highly prestigious Journal of the National Cancer Institute in June this year. The study will now be followed up by further studies of the same target group, in which researchers will look into the use of different types of artificial insemination after testicular cancer treatment.

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