Fertility and Hormone Concerns in Boys and Men With Testicular Cancer

Testicular cancer and its treatment can affect hormone levels and can also affect your ability to father children after treatment. Before treatment, it’s important to discuss the possible side effects with your doctor so you are aware of the risks and what your options might be to manage them.

Testosterone and testicular cancer

Most boys and men develop cancer in only one testicle. The remaining testicle usually can make enough testosterone (the main male hormone) to keep you healthy. If the other testicle needs to be removed because the cancer is in both testicles, or if a new cancer develops in the other testicle, you'll need to take some form of testosterone for the rest of your life. Most often, this is a gel or patch that's put on your skin, or a monthly injection (shot) given in your doctor’s office. If you need testosterone supplements, talk to your doctor about what form is best for you.

Fertility preservation

Testicular cancer or its treatment can make you infertile (unable to father a child). Before treatment starts, men who might want to father children may consider storing sperm in a sperm bank for later use. But testicular cancer also can cause low sperm counts, which could make it hard to get a good sample.

Infertility can also be an issue later in life for boys who have had testicular cancer. If a boy has already gone through puberty, sperm banking is often a good option, since the frozen samples are not damaged by long periods of storage. Researchers are also looking at techniques that might allow younger boys to father children someday.

In some cases, if one testicle is left, fertility returns after the testicular cancer has been treated. For example, fertility typically returns about 2 years after chemotherapy stops.

Even when sperm counts in semen are very low, men have several options for fathering children. Be sure to discuss any fertility concerns with your doctor before your treatment begins.

For more information, see How Cancer and Cancer Treatment Can Affect Fertility in Men.