Thinking About the Future: Fertility and Testicular Cancer
Preserving Fertility After a Testicular Cancer Diagnosis
For many men diagnosed with testicular cancer—especially those who are young and haven’t yet started or completed their families—fertility is a major concern. The good news? There are proven options to help preserve the ability to have biological children after treatment.
Sperm Cryopreservation (Freezing)
The most effective and widely recommended method of fertility preservation is sperm banking. This involves collecting and freezing sperm before treatment begins. Why before? Because chemotherapy, radiation, and even surgery can significantly damage sperm or reduce sperm production.
Studies show that the earlier sperm is collected—ideally before treatment starts—the better the chances for healthy future pregnancies. Even if only one sample can be provided, it’s still worth freezing. Multiple samples are ideal but not always possible, especially in urgent treatment situations.
Testicular Sperm Extraction (TESE)
If sperm banking isn’t possible—for example, if sperm can’t be produced or there's no sperm in the ejaculate—surgical sperm retrieval techniques like TESE may be an option. This can sometimes be done at the time of surgery (like orchiectomy) or afterward, depending on the situation.
What About After Treatment?
Even if no fertility preservation was done before cancer therapy, there may still be hope. In some cases, sperm production returns over time. And for those with lasting infertility, surgical sperm retrieval or assisted reproductive technologies (like IVF) may still offer a path to parenthood.
What Doesn’t Work?
Hormonal therapies to protect fertility haven’t been shown to be effective in males. And while experimental options like testicular tissue freezing may one day help younger, prepubertal boys, they’re not currently standard or widely available.
Key Takeaway:
If you or someone you love is facing testicular cancer, talk to your care team about fertility preservation before treatment begins. Sperm banking is fast, safe, and could make all the difference for future family-building.
Source citation: Fertility Preservation in People With Cancer: ASCO Guideline Update
H. Irene Su, Christina Lacchetti, Joseph Letourneau, Ann H. Partridge, Rubina Qamar, Gwendolyn P. Quinn, Joyce Reinecke, James F. Smith, Megan Tesch, W. Hamish Wallace, Erica T. Wang, Alison W. Loren
Journal of Clinical Oncology 00:0