Fertility Outcomes After a Single-Dose (AUC 7) Adjuvant Carboplatin Therapy for Stage I Testicular Seminoma: A Real-Life Observation

Background: Testicular seminoma is a highly curable cancer that often affects young men at the prime of their reproductive years. Since 2005, a single dose of carboplatin has been widely used as an adjuvant treatment for stage I seminoma. While this approach is effective, its impact on long-term fertility has remained uncertain. Methods: We conducted a real-world, retrospective analysis of men treated with one dose of adjuvant carboplatin for stage I seminoma between 2005 and 2024. Out of 59 initially screened patients, 18 met the inclusion criteria while 41 were excluded based on predefined eligibility criteria. We focused on the subset who later tried to conceive, using structured phone interviews to collect fertility outcomes. Results: Five patients attempted to have children after treatment, and all succeeded naturally. Interestingly, all had cryopreserved sperm before chemotherapy, but none ended up needing it. Most had minimal side effects, and none experienced serious complications or cancer recurrence. Even patients with abnormal pre-treatment semen analysis were able to father children. Conclusion: These real-life findings offer reassuring news: a single dose of carboplatin appears not to harm fertility in men treated for stage I seminoma. While sperm banking remains a safe backup, it may not be necessary for everyone. This study highlights the importance of personalized counseling and supports the continued use of single-dose carboplatin as a fertility-friendly treatment option. Larger studies are still needed to confirm these outcomes and better guide decision-making for patients and clinicians alike.