Testicular sperm retrieval at the time of bilateral radical orchiectomy

A new indication for testicular tissue cryopreservation is discussed here. We evaluate the feasibility of testicular sperm extraction during bilateral orchiectomy for testicular cancer. A 26-year-old man with a history of right orchidopexy presented with primary infertility. Tests revealed left varicocele and oligospermia. He underwent varicocelectomy but was lost to follow-up. Nine months later, he presented with right-sided solid testicular swelling. Ultrasound examination confirmed the finding of possible neoplasm and revealed contralateral intratesticular lesion. Since the patient turned azoospermic, no semen sample could be cryopreserved. Permanent histopathological sections revealed bilateral classical seminomas. On processing the fresh healthy looking specimen, normal-looking viable sperm were obtained. Future attempts at in-vitro fertilization with intracytoplasmic sperm injection should be possible. This method has been described in metachronous testicular cancer, but to our knowledge, we are the first to use it in synchronous bilateral testicular tumors.