Testicular Function After Immune‐Checkpoint Inhibitors Treatment
Authors' conclusion
ICI treatment may be associated with minimal spermatogenic dysfunction, as reflected by modest reductions in sperm output and increased serum FSH levels, despite preserved serum LH and testosterone concentrations, but mostly due to a rare (4% prevalence) case of autoimmune orchitis. The unpredictability of these effects supports routine fertility preservation counselling in young men before ICI initiation.
Study context
- Population
- Men aged 19–46 years with melanoma undergoing ICI therapy at two Australian centres, 2019–2024; prior cytotoxic chemotherapy or pelvic radiotherapy excluded26 evaluable
- Participants
- 29 men
- Exposure
- After ICI exposure vs baseline
- Outcome
- Spermatogenesis and testicular endocrine function after ICI
Methodological detailsmixed longitudinal and cross-sectional, two centres
- Mixed longitudinal and cross-sectional
- Two centres
Main finding
As reported in the abstract
- Persistent azoospermia with marked serum FSH elevation
- 1 of 26
- Median total sperm output per ejaculate declined (193-127 million per ejaculate); not statistically significant
- 34%
- Sperm concentration declined (61-43 million/mL); not statistically significant
- 30%
- Serum FSH increased on treatment; no longer significant after excluding the man with autoimmune orchitis
- p = 0.04
Observational data: associations, not effects.
Original publication
Testicular Function After Immune‐Checkpoint Inhibitors Treatment. Clin Endocrinol (Oxf). Published 14 July 2025. doi:10.
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