Fertility and hormonal function in patients with a nonseminomatous tumor of the testis.

Semen quality and serum testosterone, LH, and FSH levels were studied in 54 patients with a unilateral nonseminomatous tumor of the testis--14 before and 40 after orchiectomy. Semen analyses before and after orchiectomy gave essentially no different results: a poor semen quality was found in most men. The additional effect of a recent orchiectomy on semen quality was not demonstrable in the patients described here. Before orchiectomy, increased testosterone levels were found in patients with a beta-hCG-producing tumor. After orchiectomy serum testosterone levels were decreased, and LH and FSH levels increased. With beta-hCG-producing tumors FSH was suppressed after orchiectomy, and testosterone levels did not exceed those in patients with a tumor not producing beta-hCG. The results of semen analysis and of hormonal studies after orchiectomy suggest a dysfunction of the remaining "normal" testis. Diminished spermatogenesis and insufficient testosterone production by the Leydig cells clearly indicate anomalies already present before orchiectomy.