TESTICULAR TRAUMA - POTENTIAL IMPACT ON REPRODUCTIVE FUNCTION

Purpose: The long-term effects of testicular trauma on reproductive fu nction are unknown. In an effort to define the relationship between te sticular injury and fertility in humans, we identified patients with a history of testicular trauma and assessed parameters commonly associa ted with fertility. Materials and Methods: We reviewed 15 patients 23 to 59 years old who underwent immediate exploration after testicular t rauma between 1972 and 1991. Of the patients 11 were contacted and 8 r eturned for prospective followup. Reproductive and sexual histories, p hysical examination, measurements of serum hormones and antisperm anti bodies, semen analysis and scrotal ultrasound were done. Results: Of t he 8 patients 1 (13%) achieved and 7 (87%) did not attempt conception. Hormonal status was normal in all 8 patients. Six men had objective e vidence of subfertility by semen analysis only, although none had seve re oligospermia or asthenospermia and only 1 had severe teratospermia. Five of 9 traumatized testes were atrophic. Interestingly, only 1 pat ient had antisperm antibodies, the levels of which were probably low e nough to be clinically insignificant. Conclusions: There was definite evidence of subfertility as assessed by abnormal semen analyses and at rophic testes following testicular trauma. However, the subfertility d id not appear to be immune mediated nor did the patients present with infertility. Since only 1 patient had severely compromised fertility a ccording to semen analysis we conclude that early repair can help pres erve hormonal function as well as fertility.