Early testicular cancer: a problem in an infertility clinic

A total of 749 men attending an infertility clinic with their partners between 1 January 2004 and 31 May 2006 underwent a testicular ultrasound examination and a semen analysis around the time of their first visit. On testicular ultrasound examination, the presence of a testicular tumour was suspected in nine men. Of these, seven underwent an orchidectomy. A malignant tumour (seminomata) was present in five of these seven men, representing a malignancy incidence of 0.7% (5/749). In these five men, the semen was abnormal in three and normally fertile in the remaining two. In the two other men who underwent an orchidectomy, a benign Leydig cell tumour and an area of Sertoli cell-only were discovered, respectively. A watch was kept on the apparent tumour sites in the remaining two men, revealing no change in ultrasonic appearance over a period of 2–12 months. These data demonstrate that testicular tumours can present in an infertility clinic among men with normal as well as an abnormal semen analysis. A plea is made for the greater use of diagnostic ultrasound among infertile men.