Testicular cancer commonly affects young men who have not had the chance to start a family. Because of this, questions about post-treatment fertility are very common. Since treatment involves removing the affected testicle, fertility will be impaired afterwards. Thankfully, however, total infertility is rare. Additionally, several options exist for men with impaired fertility that help them start families. If you or your loved one has been diagnosed with testicular cancer, here are five things you need to know about how it impacts fertility.

1. Chemotherapy Has the Largest Effect on Post-Treatment Fertility

The impact of testicular cancer treatment on fertility depends heavily on the type of treatment that is used. Chemotherapy has the most impact on fertility, especially if high doses are administered. However, even chemotherapy typically does not cause permanent infertility—your fertility slowly returns over time after the chemotherapy treatment has stopped. Additionally, you shouldn't let fertility concerns stand in the way of the treatment protocol that has been suggested by your oncologist. Numerous options exist for helping men successfully start families even when their fertility is impaired, whether it's by testicular cancer or other means.

2. Preserving Your Sperm Before Treatment Can Help You Start a Family Afterwards

If you've been diagnosed with testicular cancer, you may wish to consider cryopreservation. For this procedure, you'll donate sperm to a sperm bank. The sperm bank will check the quality of the sperm sample to make sure that it's healthy, and then freeze it to preserve its viability. The process doesn't cause any damage to the sperm. Later, when you're ready to start a family, the frozen sperm can be used for in-vitro fertilization.

You'll be required to pay an up-front fee to the sperm bank along with an annual storage fee. Your insurance company may help you pay these fees if you have been formally diagnosed with testicular cancer. Cryopreservation is a good way to guard against a potential total loss of fertility after testicular cancer treatment, even though these events are rare.

3. Assisted Reproductive Technology Can Help You Start a Family When You Have Low Fertility

As mentioned above, testicular cancer treatment causes impaired fertility rather than infertility. This most often comes in the form of a reduced sperm count due to only having one testicle making sperm. Like any other man with impaired fertility, assisted reproductive technology can help you successfully start a family. These methods include in-vitro fertilization and intrauterine insemination—they help your healthy sperm successfully meet with and fertilize your partner's egg.

4. After Treatment, Don't Assume You're Infertile

If you're not ready to start a family, you should never assume that you're infertile after you have been treated for testicular cancer. You should always continue to use contraception, even if you believe that your fertility has been impacted by the treatment. This is especially important because men often slowly regain their fertility after treatment.

5. Testosterone Therapy Is Sometimes Necessary After Treatment and Can Increase Fertility

Testicular cancer treatment can sometimes cause low testosterone levels, especially as you get older. If you're suffering from the symptoms of low testosterone such as fatigue, depression, and a low sex drive, you may wish to ask your doctor about testosterone therapy. In addition to reducing your symptoms, testosterone therapy can sometimes increase your fertility.

After treatment, it's best to work with a reproductive endocrinologist to find out how the treatment has affected your fertility. Your partner's fertility levels will need to be tested as well. A reproductive endocrinologist can help you determine which methods of enhancing fertility (including assisted reproductive technology) are most suitable for your situation, giving you the best chance of successfully starting a family after testicular cancer treatment.