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Importance of infertility checks

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  • Importance of infertility checks

    Hi All,

    Long-time lurker, first time poster here. I'm a 2x, survivor that used this forum to do some research prior to my more recent orchiectomy.

    1st time: Found a lump on my descended left and had an I/O orchiectomy a few months later. Turned out it was a Stage 1 seminoma/nonseminoma tumor (I don't recall the split off-hand.) Went on surveillance.

    2nd time: 4 years later and this one was more scary. My wife and I were unsuccessful in trying to have a child in over a year. Semen analyses showed very low sperm count and bloodwork showed low testosterone. I saw a urologist and had an ultrasound done and found multiple small hypoechoic masses, confirmed by an MRI. I went to my regularly-scheduled oncologist appointment with the imaging and he saw and suggested an orchiectomy. My bloodwork for surveillance came back clean for AFP. I saw a urologist that specializes in male infertility, started banking, and had the second I/O orchiectomy & implants a week ago. Pathology came back as Stage 1 seminoma that did not appear to breach the testicle. Currently I have an appointment with a urologist for TRT, the surgeon for follow-up and my oncologist for next steps (surveillance or chemo/radiation.)

    The first one was a clear-cut tumor. The second came about due to unsuccessfully trying to have a kid for a long period. Had I not went to the doctor at my wife's urging, I would not have known about the masses and likely not have caught it until much later.

  • #2
    Thanks for sharing!
    10/5/2018 - Ultrasound finds tumor
    10/20/2018 - Left I/O
    10/25/2018 - Doc says stage 1a. Pathology : Mixed Germ Cell Tumor; Seminoma (95%) and Teratoma, tumors 3.2cm and 2.4cm; Rete Testis invasion w pagetoid spread and stromal invasion

    Comment


    • #3
      Your doc should have set you up with trtbefore the surgery, not weeks later. Mine did the same thing to me & I simply cannot understand how someone with so much education could not realize that a guy with no nuts needs trt!

      I would get on the phone & INSIST they write a prescription.

      Dave
      Jan, 1975: Right I/O, followed by RPLND
      Dec, 2009: Left I/O, followed by 3xBEP

      Comment


      • #4
        From what I have read over the years there does seem to be an increased right of testicular cancer in infertile/sub-fertile men. Scrotal imagining seem to be appropriate, but knowing when the tumors will form, etc. I think makes routine ultrasound screening a bit unreasonable long-term but should reiterate the need for monthly testicular self-exams, even if the first ultrasound is negative, just as a precaution.

        Mike
        Oct. 2005 felt lump but waited over 7 months.
        06.15.06 "You have Cancer"
        06.26.06 Left I/O
        06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
        06.30.06 It's Official - Stage I Seminoma
        Surveillance...
        Founded the Testicular Cancer Society
        6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

        For some reason I do not get notices of private messages on here so please feel free to email me directly at mike@tc-cancer.com if you would like to chat privately so as to avoid any delays.

        Comment


        • #5
          Originally posted by Davepet View Post
          Your doc should have set you up with trtbefore the surgery, not weeks later. Mine did the same thing to me & I simply cannot understand how someone with so much education could not realize that a guy with no nuts needs trt!

          I would get on the phone & INSIST they write a prescription.

          Dave
          I reached out to him in advance of the surgery after reading some of your posts and he suggested that either he could do it or I could try my PCP or a urologist closer to home. I opted for the latter (visits with the surgeon were more expensive and further away) and set up an appointment with my urologist before my follow-up. I did get a shot of testosterone after my surgery to last me a few weeks, which helped, so I should be ok. I definitely appreciate you sharing your situation on here that put it in my mind up front.

          Comment


          • #6
            Originally posted by Mike View Post
            From what I have read over the years there does seem to be an increased right of testicular cancer in infertile/sub-fertile men. Scrotal imagining seem to be appropriate, but knowing when the tumors will form, etc. I think makes routine ultrasound screening a bit unreasonable long-term but should reiterate the need for monthly testicular self-exams, even if the first ultrasound is negative, just as a precaution.

            Mike
            Agreed on routine ultrasounds unreasonable. In my situation, a self-exam wouldn't have caught anything because the masses too small to physically feel, although my oncologist was able to locate them when he tried. I got the ultrasound to see if there were any physical blockages or anything that were impeding our attempts, turns out it was a much more serious situation. When I talked to my surgeon (who specializes in male infertility), he noted that my low counts made sense with the germ cells being impacted, as the cancerous cells couldn't produce as much. In that front, I'm hoping what I have banked is sufficient for IVF.

            Self exams should be regular no matter what.

            Comment


            • #7
              Good luck with IVF, Proto Man!! I had very low count after chemo (less than 1% viable), but it's enough for ICSI and the IVF worked for us!
              July 2016 - Left I/O
              December 2016 - BEPx3
              All clear for 1 year!

              My Testicular Cancer Support Kit
              First Oncologist Visit Checklist
              Simplify Cancer Podcast

              Comment


              • #8
                Originally posted by JoeTheAstronaut View Post
                Good luck with IVF, Proto Man!! I had very low count after chemo (less than 1% viable), but it's enough for ICSI and the IVF worked for us!
                Thanks Joe! It's encouraging to see similar situations work out, really happy for you!

                Comment


                • #9
                  Quick update: My urologist put me on Androgel for now. Hopefully my new insurance will cover pellet injections in the future.

                  Comment


                  • #10
                    Honestly. I have not heard from many guys on pellets, but not many of those seem happy with them. The generic version of androgel seemed to work best for me. The once every 3 week injection is actually more convenient, but seems to vary more in desired results than the gel.

                    Dave
                    Jan, 1975: Right I/O, followed by RPLND
                    Dec, 2009: Left I/O, followed by 3xBEP

                    Comment


                    • #11
                      Off subject a little bit but I can't figure out how to start a new post. Son had sperm banked before I/O and 3XBEP which he finished Nov 2017. Sperm banking is costing 700 for storage which insurance does not pay for. Another bill will be coming in January. Would it be worth him having his sperm tested and if everything is okay, let the stored sperm go?

                      Comment


                      • #12
                        Hi Ann,

                        I am the same, don’t know how to start a new post.My son had done his sperm banking as well. He got all the tests when the hospital storages. If there is something wrong then they informed me. But I don’t know your situation. Just for your information.

                        BRs

                        Amy, Ryan’s mum

                        Comment


                        • #13
                          Hi Amy - What I'm thinking is his cancer treatment is complete except for follow ups. If new analysis on sperm shows everything is okay then we would not need the banked sperm anymore. It would save us the 700 storage fee. Or do keep just in case?

                          Comment


                          • #14
                            I got. Then I agree with you!
                            My original plan was only make it for two years after chemo, in case his infertility is effect from chemo.

                            BRs

                            Amy

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