Background: TC represents 1% of male neoplasms but it is the most common in young adults. Interdisciplinary management with chemotherapy, radiotherapy and surgery has led to a 10-year relative survival rate of up to 95%. These treatments (Tx) have short- and long-term side effects. While sexual dysfunction can reduce fertility, psychosocial distress can create relationship problems and finally affect the ability to procreate. Methods: From February 2020, we submitted a series of questionnaires to all the patients (pts) currently followed-up at the Istituto Oncologico Veneto free from TC recurrence for at least 2 years from the last Tx. International Index of Erectile Function (IIEF-15) and Premature Ejaculation Diagnostic Tool (PEDT) were used. We also set up a questionnaire to investigate paternity and family status. Data about disease and treatments were collected from medical records. Results: 84 TCS completed the questionnaires, clinical data are reported in the table below. 29,8% of pts fathered children before diagnosis with a strong correlation with older age at diagnosis (45,4 vs 30,8 years, p<0,001). After Tx, 14 pts had children: 9 of which naturally, 2 out 6 were successful via assisted reproductive technology (ART) (including one patient that received high-dose chemotherapy and stem cell transplantation), 3 via adoption. 89,3% of pts had stable relationships. Of pts who did not have children: 13,1% claimed to be due to lack of a partner, 39,3% claimed to be unready, while 14,3% had tried unsuccessfully to conceive. While 28,6% pts claim to currently have fertility issues, only 8,3% of pts reported to have these issues before diagnosis. 70,2% of pts performed a spermiogram after Tx, 10 pts had spermatogenic impairment. Higher rate of sexual dysfunction after Tx was detected by questionnaires while only 4 pts claimed to have had a pre-existing issue prior to TC diagnosis. PEDT shows that 38,1% had premature ejaculation and that in 22,6% this issue is highly probable. IIEF confirms a high rate of erectile dysfunction (14,3% severe and 10,7% mild or moderate). No correlations were identified between sexual dysfuntion and previous Tx. Conclusions: Most TCS had not planned fatherhood while 16,7% had children after Tx and 14.3% tried unsuccessfully to conceive. ART and adoption is possible but challenging and little used. PEDT and IIEF found high rates of sexual dysfunction but no association with previous Tx were found.

BEP=bleomycin etoposide cisplatin; RPLND=retroperitoneal lymph node dissection.