Impact of Testicular Cancer on Male Fertility

Testicular cancer (TC) leads to infertility through a multifactorial pattern including intrinsic testicular damage, systemic effects, endocrine disruption, possible autoimmune effects, and possible congenital abnormalities in the maturation of the testis. Additionally, the long-term impact of treatment modalities on fertility and hormonal profile is related to patient’s age, as well as the type and intensity of the oncological treatment. Moreover, the treatment protocols for TC have several associated gonadotoxic and sexual dysfunction risks and may lead to decreased fertility and subsequent negative impact on patients’ quality of life. Sperm cryopreservation is the mainstay of the fertility preservation in TC patients and should be advised to all patients in reproductive age before cancer treatment. Clinicians should be aware of the treatment consequences and the different therapeutic options. In this chapter, we will go through the details of the most relevant mechanisms that link TC with male infertility.