The association of male subfertility and testes cancer is well known. The incidence of testicular carcinoma is reported to be 3.7 per 100000 per year and represents 1% -2 % of all neoplasms in men. An American man has a 1 in 500 lifetime risk of developing testes cancer [31]. Although testicular malignancies are considered to be relatively rare forms of cancer, they are the most common solid organ tumors in men aged 15-35 years of age. Survival rates of patients with testicular carcinoma have improved dramatically since the introduction of cisplatinbased combination chemotherapy. Current 5-year disease-free survival rates are approximately 95Β°70 for patients with stage I and II disease and nearly 80% for those with state III disease [29]. With the achievement of improved long-term survival in patients with testes cancer, more attention is being placed on morbidity.
As these cancers primarily affect men in their peak reproductive years, fertility issues are of major importance to this patient population. The purpose of this article is to review the etiology of fertility impairment in patients with testicular germ-cell tumors and to discuss the subsequent evaluation and treatment of the subfertile man after testes cancer.