Table 4.

Recommended examinations for primary staging

Test	Patients
Physical examination	All patients
Ultrasonography of the testes	All patients
Serum tumour markers	All patients
AFP
β-hCG
LDH
Chest/abdominal/pelvic CT	All patients
Cranial MRI	Symptomatic patients and patients in the IGCCCG poor prognosis group, or patients with multiple pulmonary metastases and/or high β-hCG values (>5,000 IU/L)
Further diagnostics	Patients with unfinished family planning, active or postponed desire for offspring as well as for ruling out/detecting hypogonadism
Fertility tests
Sperm analysis/cryopreservation
Testosterone
LH
FSH

AFP, α-fetoprotein; hCG, human chorionic gonadotropin; LDH, lactate dehydrogenase; CT, computed tomography; IGCCCG, International Germ Cell Cancer Collaboration Group; LH, luteinizing hormone; FSH, follicle-stimulating hormone. We recommend advising all patients on the cryopreservation of sperm preferably before the primary surgical intervention and, if necessary, arrange consultation with an andrologist or a fertility centre.