What should men with testicular cancer know about fertility, and what questions should they ask their doctor?
When a young man is diagnosed with testicular cancer, he will often have a low sperm count because of the cancer itself and even before the orchiectomy. Interestingly, sometimes the diagnosis of testicular cancer is first suggested because a couple is unable to conceive. The wife is found to be healthy, but the husband is found to have a mass in a testicle due to testicular cancer, and the infertility is due to the cancer itself. If an RPLND is to be performed, it is important that a nerve-sparing RPLND be done by an expert urologist who is experienced with this procedure. When done in capable hands, close to 100% of patients will have normal ejaculation and little or no impairment in fertility (ability to father a child) after an RPLND. When chemotherapy is necessary, 60% of the men will recover their sperm count to a normal level and have no problems with fertility. However, it takes at least a year for recovery to occur. The lower the sperm count at the start of chemotherapy, the lo
