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[Testicular cancer and male fertility].

Disorders of fertility after treatment of testicular cancer constitute important sequelae. Almost one half of patients initially present decreased fertility. Chemotherapy, radiotherapy and surgery each exert their specific harmful effects. Although the desire for subsequent paternity is often satisfied spontaneously, some patients remain permanently sterile. Systematic semen storage, designed to palliate this sterility, when necessary, must be systematically part of the therapeutic contract. It is best performed before or immediately following castration. It also plays a psychological role, projecting the patient into his future cure. The limits of freezing have been considerably reduced with progress in vitro fertilization and ICSI. In the case of radiotherapy or chemotherapy, effective contraception must be recommended for 2 years after starting treatment. The long-term teratogenicity of the various treatments used is still very poorly known.