A group of 218 patients with unilateral germinal testicular cancer was investigated with biopsy from the contralateral testis and/or semen and hormone analyses after orchidectomy but before irradiation and chemotherapy. In 24% of the biopsies severe irreversible changes such as spermatogenic arrest, Sertoli cell-only tubules, hyalinized tubules, or carcinoma in situ were found. Serum testosterone (T) values were below the reference interval in 13% of the patients, whereas 12% had normal serum T values in combination with elevated serum luteinizing hormone (LH). Most serum follicle-stimulating hormone (FSH) values were above the reference interval. The impairment of gonadal function in the patients could be explained partly by the removal of one of the testes, by premorbid defects of spermatogenesis in the contralateral testis, and by elevated serum human chorionic gonadotropin (hCG) values caused by the cancer.
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