Preserving Reproductive Potential in the Solitary Testis With Germ Cell Tumour and Azoospermia Using Onco-Testicular Sperm Extraction (TESE): A Case Report

Patients with germ cell tumours in solitary testis have significantly reduced fertility potential. Preserving fertility is crucial for improving quality of life and providing patients with the opportunity to conceive in the future if desired. This study introduces a novel technique for fertility preservation in patients who would otherwise face infertility. We describe a novel surgical technique in a 29-year-old patient with a germ cell tumour in the solitary testis and a history of previous orchidectomy for undescended testis. On-table extraction of viable spermatozoa was performed during tumour excision to preserve the patient's reproductive potential. Spermatozoa and testicular tissue samples were sent for histopathological analysis to determine the feasibility of extraction. The pathology report confirmed the presence of normal testicular tissue within the affected testis, allowing for the successful extraction of viable spermatozoa. These spermatozoa were subsequently used for successful oocyte fertilisation via intracytoplasmic sperm injection (ICSI). This technique enables the extraction of viable spermatozoa from patients with a germ cell tumour in the solitary testis. It offers a viable fertility preservation strategy for male patients undergoing orchidectomy or partial orchidectomy with adjuvant chemoradiotherapy. Additionally, this approach enables histopathological confirmation of spermatozoa viability before radical orchidectomy, optimising fertility preservation.