Seminoma discovered in two males undergoing successful testicular sperm extraction for intracytoplasmic sperm injection

Objective: To describe two cases with testicular seminoma incidentally discovered at the time of successful testicular sperm extraction for intracytoplasmic sperm injection (ICSI). Design: Report of two cases. Setting: Tertiary care academic center. Patients: Two males with nonobstructive azoospermia with history of cryptorchidism. Intervention: Testicular biopsy combined with ICSI; orchiectomy with radiotherapy. Results: From two couples and in three different cycles, 17 of 55 (31%) metaphase II oocytes fertilized after microinjection. Eleven of these fertilized oocytes cleaved normally and all 11 were replaced. One twin pregnancy was established and was delivered successfully later. In both cases, a seminoma was discovered at the time of testicular biopsy. Conclusions: At the time of testicular biopsy for ICSI, a specimen for histopathology must be sent to exclude the presence of seminoma in males with nonobstructive azoospermia with a history of cryptorchidism. The effectiveness of testicular sperm extraction in combination with ICSI also has been demonstrated even against the background of testicular tumor.