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Even though surgical removal of one testis does not affect the sperm-producing ability of the remaining testis, both radiotherapy and chemotherapy can lower sperm counts temporarily or permanently. Men with testicular cancer often have lower fertility before treatment starts. Treatment can reduce this fertility further. Men who have both testes removed will no longer be able to father children.
All men who are diagnosed with testicular cancer should receive advice from their doctors about fertility concerns. It is highly recommended that men produce semen samples (through masturbation) for sperm storage (sperm banking). Sperm storage must take place before chemotherapy or radiotherapy starts, or surgery if both testes are to be removed. Semen can be frozen, using special equipment, and stored long-term for future use. If men want children at a later stage, the frozen semen is thawed and used in fertility treatments such as IVF (in vitro fertilisation).
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Photo courtesy of Monash IVF
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 More information: Assisted Reproductive Technologies
When should sperm be stored?To avoid delaying treatment for testicular cancer, it is important to think about sperm storage early and before treatment starts. Some men may have poor sperm counts and may need to visit the sperm-banking unit on two or three separate occasions. Even if the sperm quality before treatment is poor, sperm storage should still be considered. With advances in reproductive technologies, just a few sperm can be used successfully to produce children at a later stage.  Back to top
Should teenage patients think about storing sperm?Sperm storage for teenagers with testicular cancer can be a difficult issue and needs careful and delicate handling. Coping with the diagnosis of cancer at a young age and any body image problems following surgery can be extremely difficult. Fatherhood is not likely to be a main concern. Producing a semen sample by masturbation can also be stressful for a very young man in these situations.
Family support and encouragement without pressure can be extremely valuable. Parents may need to talk about future fertility problems to their child. Back to top
Where can sperm be stored?Sperm is frozen using special technologies and then kept in liquid nitrogen (-196oC) for long-term storage.
Specialist reproductive centres providing IVF and other assisted reproductive technologies usually also offer long-term sperm storage facilities. For more information speak to a specialist or contact a local infertility clinic.
 Related link: The Fertility Society of Australia
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