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Purpose Subfertility is a well-known aftermath of treatment of testicular germ cell tumours (GCTs). Growing evidence suggests reduced semen quality also before therapy. The present study aimed to evaluate pre-orchiectomy semen parameters in GCT patients and to compare the results with controls. Methods GCT patients providing semen for cryopreservation before orchiectomy during 2012 - 2023 were retrospectively enrolled (TT cohort). Controls consisted of healthy volunteers for sperm donation (HD), and of patients with other malignancies (OM). The following parameters were recorded in each participant: ejaculate volume (EV; ml), total sperm count in ejaculate (TSC), and proportion of progressive motility (PM) (%). Descriptive statistical methods were used to compare the 3 populations with each other. Results A total of 664 subjects were included, thereof 163 TT, 289 HD, and 212 OM. Median ejaculate volume was 3.0 ml, 3.5 ml, and 3.4 ml; median TSC was 56.9 x106, 207 x106, and 152 x106; median PM was 40%, 40.2%, and 43% in TT, HD, and OM, respectively. TSC, EV and several secondary parameters of semen quality observed in TT were significantly worse than those in the two control cohorts. HD and OM were within normal limits with regard to TSC and PM and were different in only a few secondary parameters. Conclusion This study confirmed significantly lower pre-orchiectomy semen quality in GCT patients in comparison to healthy males and to patients with other malignancies. Subfertility is an intrinsic feature of GCT preceding treatment that needs to be considered by care-givers., (S. Karger AG, Basel.)

Purpose: Previous studies suggested that serum levels of microRNA (miR)-371a-3p (so-called M371 test) have a much higher sensitivity and specificity than the classic markers of testicular germ cell tumors (GCTs) and are applicable toward both seminoma and nonseminoma. We sought to confirm the usefulness of this test as a novel biomarker for GCT., Patients and Methods: In a prospective, multicentric study, serum samples of 616 patients with testicular GCTs and 258 male controls were examined for serum levels of miRNA-371a-3p (miR levels) by quantitative polymerase chain reaction. The GCT population encompassed 359 patients with seminoma and 257 with nonseminoma; 371 had clinical stage I disease, 201 had systemic disease, and 46 had relapses. Paired measurements before and after orchiectomy were performed in 424 patients; 118 with systemic disease had serial measurements during treatment. miR levels were compared with those of β-human chorionic gonadotropin, α-fetoprotein, and lactate dehydrogenase., Results: For the primary diagnosis of GCT, the M371 test showed a sensitivity of 90.1%, a specificity of 94.0%, an area under the curve of 0.966 upon receiver operating characteristic analysis, and a positive predictive value of 97.2%. α-Fetoprotein, β-human chorionic gonadotropin, and lactate dehydrogenase had sensitivities of less than 50% in seminoma and slightly higher sensitivities in nonseminomas. miR levels were significantly associated with clinical stage, primary tumor size, and response to treatment. Relapses had elevated miR levels that subsequently dropped to normal upon remission. Teratoma did not express miR-371a-3p., Conclusion: The M371 test outperforms the classic markers of GCT with both a sensitivity and a specificity greater than 90%. All histologic subgroups, except teratoma, express this marker. The test could be considered for clinical implementation after further validation.