Men who have a history of infertility appear to be at heightened risk of testicular cancer, according to the largest study ever done to examine the issue. The findings also suggest that infertility and testis cancer may share common etiologic factors.

Researchers at the University of California, San Francisco (UCSF) School of Medicine studied couples evaluated for infertility at 15 centers throughout the state. They found that testicular cancer was up to 3.5 times more likely to develop in male partners of infertile couples than in men in the general population.

“We think there are underlying exposures or genetics that contribute to both conditions. We don’t think that infertility treatment is contributing to testis cancer development,” said Thomas Walsh, MD, clinical instructor of urology at UCSF. He presented the study findings at the recent American Society for Reproductive Medicine meeting in Washington, D.C.

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“It may be that infertility or an abnormal semen analysis is an early marker for future problems in these men,” says co-investigator Paul Turek, MD, professor of urology at UCSF. He said infertile men should do testicular self-exams every month.