Together Logo To main site

Understanding My Fertility: A Guide for Males

When you are first diagnosed with a medical condition, it can feel overwhelming. You might be navigating decisions about your treatment plan, going to lots of appointments, and trying to adjust to a new “normal.”

On top of that, you might be worried about potential side effects and how your illness and treatments might impact you, both now and in the future.

One of the topics that may come up is your fertility. This guide is designed to help make conversations about fertility and having children a little easier.

Not everything in this guide will apply to your situation. Some options may not fit with your treatment plan. However, understanding your choices can help you make a plan that works for you.

What is fertility? 

Fertility refers to your body’s ability to father a child. For males, fertility is primarily about the ability to make healthy sperm that can fertilize an egg. When something interferes with your reproductive system and prevents you from getting your partner pregnant, this is called infertility.

Your medical condition or its treatment might impact your reproductive system and how it functions. Fertility preservation involves taking steps to protect your fertility so you have better chances of fathering children in the future.

Male reproductive system 

To understand fertility, it’s important to know how the male reproductive system works. You may have learned about this in school or talked about it with someone before. Even if you don’t see yourself having children, your reproductive system is still a key part of your overall health.

Here’s a quick overview of the male reproductive system:

Parts of your reproductive system

The male reproductive system includes the testicles (testes), scrotum, penis, urethra, epididymis, vas deferens, seminal vesicles, and prostate.

  • Testicles (Testes): The testicles are two oval-shaped organs located in the scrotum. They make testosterone and sperm.
  • Scrotum: The scrotum is a sack of skin that holds and protects the testicles. It also keeps them at the right temperature to make sperm.
  • Penis: The penis is the part of the male body used for urination and reproduction. It delivers sperm into the female body during sex.
  • Urethra: A tube that runs through the penis to transport urine and semen.
  • Epididymis: The epididymis is a coiled tube at the back of each testicle. It stores and matures sperm.
  • Vas deferens: The vas deferens is a long tube that carries sperm from the epididymis to the urethra.
  • Seminal vesicles and prostate: These glands make fluids that combine with sperm to form semen.

The brain also plays a role in reproduction. The hypothalamus and pituitary gland release chemical messages called hormones to tell your body to make sperm and testosterone.  

male reproductive system from front

Parts of the male reproductive system (frontal view).

male reproductive system from side

Parts of the male reproductive system (side view).

Puberty

Puberty is the stage in life when your body undergoes physical and hormonal changes that prepare you for adulthood. This typically occurs between the ages of 9 and 16 for males. 

During puberty, the hypothalamus and pituitary gland signal the testicles to produce testosterone. Testosterone is a hormone that helps your body grow and develop during puberty. It triggers changes such as the growth of facial and body hair, a deeper voice, and the production of sperm. 

Sperm production and fertility

Sperm are tiny cells made by the testicles. If a sperm and egg join together, it can result in a pregnancy. Sperm production begins at puberty and continues throughout your life.

From the testicles, sperm move to the epididymis, a coiled tube where they are stored and continue to mature. During sexual activity, sperm travel through the vas deferens, a tube that carries them to the urethra. Along the way, sperm mix with seminal fluid to create semen. When a person reaches orgasm, semen is released through the urethra in a process called ejaculation.

Fertility depends on several factors, including:

  • The number of sperm you produce (sperm count)
  • The shape of the sperm (morphology)
  • The ability of the sperm to move effectively (motility)

How treatment can affect fertility

Your illness or its treatment may impact your reproductive system, leading to problems with fertility such as:

  • A decrease in sperm count or quality
  • Hormonal changes that affect sperm production
  • Damage to the testicles or other parts of the reproductive system

Some changes may be temporary and go away after treatment. Other changes could be long-term or permanent. 

It’s important to discuss how your treatment might affect your fertility with your care team so you can explore your options.

What are some fertility preservation options?

The options available to preserve your fertility depend on factors such as your age, treatment plan, and overall health.  

Here are some possible options for males: 

  1. Sperm banking (sperm freezing or cryopreservation)

    What is it?

    Sperm banking involves collecting and storing your sperm for future use. This is also known as sperm freezing or cryopreservation. 

    How does it work?

    You provide a semen sample, which is then frozen and stored in a lab. 

    What happens when I am ready for kids?

    When you’re ready to have a child, the frozen sperm can be thawed. Then the sperm might be used to fertilize an egg in the lab (in vitro fertilization or IVF) or placed directly into your partner’s uterus (intrauterine insemination or IUI). 

    Anything else I should know?

    • This is the most common and straightforward option for males. 
    • It’s non-invasive and the sperm can be collected quickly before treatment begins. However, you must have healthy sperm and be able to provide a sample.

  2. Testicular sperm aspiration or extraction

    What is it?

    Testicular sperm extraction involves removing tissue to collect sperm directly from the testicles. 

    How does it work?

    A needle is inserted into the testicle to remove the sperm (aspiration) or a small incision is made in the testicle to remove tissue (extraction). After extraction, the tissue is examined under a microscope to identify and collect sperm. The collected sperm are frozen after aspiration or extraction.

    What happens when I am ready for kids?

    When you’re ready to have children, the frozen sperm can be thawed and used for fertility procedures like in vitro fertilization (IVF).

    Anything else I should know?

    This procedure may be used if you don’t have sperm in your semen or if you are unable to give a sperm sample by masturbation. 

    It’s a surgical procedure done under local or general anesthesia.

  3. Testicular tissue freezing (testicular tissue cryopreservation)

    What is it?

    Testicular tissue freezing involves removing a small piece of testicular tissue and freezing it for future use. This is mainly used for males who have not gone through puberty.

    How does it work?

    You’ll have a minor surgical procedure to remove the tissue. The tissue contains immature cells, which may be used later to try to produce mature sperm.

    What happens when I am ready for kids?

    Researchers are working on ways to use this tissue to create mature sperm for fertility treatments.

    Anything else I should know?

    • This option is experimental and must be done through a research protocol.
    • It may be considered for boys who haven’t gone through puberty yet. 

  4. Embryo freezing (embryo cryopreservation)

    What is it?

    In embryo freezing or cryopreservation, eggs from a partner or donor are fertilized with your sperm. The fertilized egg (embryo) is frozen. 

    How does it work?

    Your sperm are collected and then used to fertilize an egg in a lab (in vitro fertilization or IVF). The fertilized egg develops into an embryo. Then the embryo is frozen and stored for later use.

    What happens when I am ready for kids?

    When you are ready to have a child, you and your female partner or surrogate will see a fertility specialist. Your partner will need to take hormones to prepare their uterus for the embryo. The embryo is thawed and placed in your partner’s uterus to begin the pregnancy. 

    Anything else I should know?

    • To be a candidate for this option, you must be at least 18 years old.
    • You need an egg donor at the time of the procedure. 
    • You need a partner or surrogate to carry the baby when you are ready to have a child.

  5. Testicular sheilding

    What is it?

    A protective shield is placed over the testicles during radiation therapy to reduce exposure.

    How does it work?

    The shield blocks radiation from damaging the testicles.

    What happens when I am ready for kids?

    If the shielding is effective, your testicles may still produce healthy sperm.

    Anything else I should know?

    • This option is only applicable to patients undergoing radiation therapy. 

Other options for having children later 

If fertility preservation isn’t possible or effective, there are still ways to have children, such as using donor sperm or adoption.  

You may also decide that having children isn’t the right choice for you, and that’s okay too. Only you can decide what’s best for your future. 

Your care team can help you navigate these decisions and make the best choice for your future. 

Key points about taking control of your fertility

  • A healthy reproductive system is essential for your ability to make sperm and father a child (fertility). 
  • The male reproductive system includes the testicles (testes), scrotum, penis, urethra, epididymis, vas deferens, seminal vesicles, and prostate.
  • Infertility occurs when your reproductive system doesn’t function properly.
  • It’s important to discuss fertility preservation options with your care team before starting treatment.
  • Options for preserving fertility include sperm freezing, testicular tissue freezing, and shielding during radiation.

Related Factsheets

Find more information

—
Reviewed: October 2025

Related content

  • Understanding My Fertility: A Guide for Females

    Fertility problems (infertility) can be a side effect of illness or treatments. Learn about female fertility preservation options and how to talk to your doctor.

  • Male Reproductive Health Issues

    Childhood cancer therapy may sometimes affect male reproductive functions later in life. It is important that boys who are at risk for reproductive health problems have a yearly check-up for related concerns.

  • Female Reproductive System Problems

    Some female childhood cancer survivors may experience problems with their reproductive health — menstrual periods, pregnancy, and childbearing — because of certain treatments they received.