Testicular cancer and its care can affect sex and fertility. Some problems are:

  • No sperm cells or hormones can be made if both testicles are taken out. This means you won't be able to father children. It will also cause problems in how your body works. Keep in mind that 1 healthy testicle can make enough sperm and hormones.
  • Nerve or blood vessel damage.

Sexual Function

Nerves, blood vessels, and hormone signals all plays a role in sex. Testicular cancer or its care may cause:

  • Erectile dysfunction—Problems with or inability to get or keep an erection
  • Retrograde ejaculation—Semen is sent to the bladder instead of out of the body during ejaculation; this can be caused by nerve or muscle damage
  • Pain during sex—You may have some irritation in the prostate gland or urethra
  • Lower sex drive—May be caused by change in hormones

There are many ways to treat these problems. Medicines and hormone replacement may help. In severe cases, surgery and certain devices may be needed.

Fertility Preservation

Male fertility is changed by any care aimed at the genitals. Most men have reduced or zero sperm counts while they're being treated. For the most part, sperm counts will rise after it's over. But this can take up to 4 or more years. Your age or how long you were treated play a role.

To preserve fertility, sperm can be banked before you get treated. This also works for boys who have reached puberty. Sperm banking is collecting and freezing semen. When it's time to start a family, it's thawed and used to fertilize eggs. For boys who have not reached puberty, you can think about preserving testicular tissue. But it's not known how well this works.

Have an honest talk with your doctor about any problems or concerns you have. Your doctor may send you and your partner to a counselor for help.


Cancer and fertility. NCCN—National Comprehensive Cancer Network website. Available at: https://www.nccn.org/patients/resources/life_with_cancer/fertility.aspx. Accessed October 3, 2020.

Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/testicular/patient/testicular-treatment-pdq#section/_50. Accessed October 3, 2020.

Treating sexual problems for men with cancer. American Cancer Society website. Available at: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/sexuality-for-men-with-cancer/sex-problems.html. Accessed October 3, 2020.

Last reviewed September 2020 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP  Last Updated: 12/18/2020