Evidence map›Paper›PMID 39189883›Full record

SynthesisAndrology2025

Oncological treatments have limited effects on the fertility prognosis in testicular cancer: A systematic review and meta-analysis.

Janna Pape, Jancy Fernando, Dimitrios Megaritis, Susanna Weidlinger, Angela Vidal, Frédéric D Birkhäuser, Tanya Karrer, Michael von Wolff

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Andrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Article
  6. Review
  7. Article
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Janna PapeDivision of Gynecological Endocrinology and Reproductive Medicine, University Women's Hospital, Inselspital Bern, University of Bern, Bern, Switzerland.ORCID 0000-0002-7858-2288
Jancy FernandoFrauenarztpraxis Langenthal, Langenthal, Switzerland.ORCID 0009-0003-6990-9300
Dimitrios MegaritisDivision of Gynecological Endocrinology and Reproductive Medicine, University Women's Hospital, Inselspital Bern, University of Bern, Bern, Switzerland.ORCID 0000-0002-7448-6838
Susanna WeidlingerDivision of Gynecological Endocrinology and Reproductive Medicine, University Women's Hospital, Inselspital Bern, University of Bern, Bern, Switzerland.ORCID 0000-0002-1846-1628
Angela VidalDivision of Gynecological Endocrinology and Reproductive Medicine, University Women's Hospital, Inselspital Bern, University of Bern, Bern, Switzerland.ORCID 0000-0002-3229-6200
Frédéric D BirkhäuserDepartment of Urology, Urology St. Anna, Lucerne, Switzerland.ORCID 0000-0002-8166-2131
Tanya KarrerMedical Library, University Library Bern, University of Bern, Bern, Switzerland.ORCID 0000-0003-1200-7149
Michael von WolffDivision of Gynecological Endocrinology and Reproductive Medicine, University Women's Hospital, Inselspital Bern, University of Bern, Bern, Switzerland.ORCID 0000-0003-4303-2734

Funding

Krebsliga SchweizSwiss Cancer League KLS-5650-08-2022
6 · The paper itself

Abstract

backgroundTesticular cancer is the most common solid tumour among young men in the reproductive phase. After completing cancer treatment, up to 77% of cancer survivors report an interest in paternity after completing cancer treatment. To preserve fertility, most guidelines recommend that physicians should counsel their patients about sperm cryopreservation before initiating gonadotoxic therapy. However, few studies have assessed fertility parameters after testicular cancer therapies over the last 20 years.

objectivesTo close the gap of data regarding gonadotoxicity of testicular cancer therapies to enable more accurate counselling regarding fertility preservation. MATERIALS AND

methodsA systematic literature search was conducted in Medline, Embase and Cochrane until December 2022. The systematic review included studies of men who had undergone all types of unilateral testicular cancer treatment, whereas the meta-analysis excluded studies with unspecified treatments, less than 10 patients for outcome evaluation or rare tumours. Infertility (i.e. azoospermia, failure to achieve paternity or the usage of cryosperm) was defined as outcome.

resultsThe qualitative analysis included 30 studies with a total of 13,718 men after unilateral testicular cancer. Treatment comprised active surveillance after unilateral orchidectomy (32.7%), radiotherapy (23.1%), standard- or low-dose chemotherapy (33.7%) and high-dose chemotherapy (1.4%). Post-treatment spermiograms were analysed in 17 studies. The quantitative synthesis included 23 studies, revealing an overall pooled prevalence of infertility (95% CI) of 14% (9%-21%). Azoospermia occurred in 8% (6%-12%). For good-prognosis patients who received standard therapy, the overall prevalence of infertility was only 4% (2%-10%).

conclusionSo far, this very first meta-analysis of overall infertility prevalence provides the best approximation of fertility prognosis for men who have undergone testicular cancer therapy. Despite the low prevalence of infertility, it is still recommended to undergo sperm cryopreservation because of the uncertainty of the subsequent therapy and the lack of large longitudinal data on individual treatment effects.

Indexed as

Fertility PreservationInfertility, MaleTesticular NeoplasmsCryopreservationHumansMalePrognosisazoospermiacryospermfertility preservationinfertilityoncological treatmenttesticular cancer

Identifiers

PMID39189883
PMCPMC12006886

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.