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The Capital Region of Denmark - a part of Copenhagen University Hospital
E-pub ahead of print

Paternity After Treatment for Testicular Germ Cell Cancer: A Danish Nationwide Population-Based Cohort Study

Research output: Contribution to journalJournal articleResearchpeer-review

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BACKGROUND: Testicular germ cell cancer (TC) incidence peaks in the reproductive age but knowledge on fertility after treatment is insufficient. The aim was to evaluate paternity after today's testicular cancer (TC) treatment.

METHODS: Clinical data were extracted from the Danish Testicular Cancer database and patients were divided into four groups: 1) Surveillance; 2) Bleomycin, etoposide, and cisplatin (BEP); 3) BEP + post-chemotherapy retroperitoneal surgery (BEP + surgery); and 4) Abdominal radiotherapy. For each patient, 10 men matched on date of birth were randomly sampled from the normal population. Paternity was defined as date of birth of first child after TC treatment with or without the use of assisted reproductive technology (ART) and was assessed by linkage to the Danish Medical Birth Register and the Danish in vitro fertilization (IVF)-register.

RESULTS: We included 4,846 unilateral TC patients and 48,456 men from the normal population. The 20 years predicted chance of obtaining fatherhood for a 30-year-old man was 39.7% in TC patients compared to 42.5 % in the normal population. The chance of obtaining fatherhood was statistically significantly decreased after BEP (hazard ratio [HR] = 0.87, 95% confidence interval [CI] = 0.78-0.97) and BEP + surgery (HR = 0.74 95% CI = 0.63-0.87), but not after radiotherapy (HR = 0.89, 95% CI = 0.75-1.06) or surveillance (HR = 0.95, 95% CI = 0.89-1.02). The risk of needing ART to obtain fatherhood was increased after all treatment modalities.

CONCLUSION: The chance of obtaining fatherhood after TC treatment was substantially higher than previously reported. Patients followed on a surveillance program had a similar chance of obtaining fatherhood as non-cancerous men.

Original languageEnglish
JournalNational Cancer Institute. Journal (Online)
ISSN1460-2105
DOIs
Publication statusE-pub ahead of print - 28 Jun 2021

ID: 66625950