The outlook for fertility among patients who are treated for testicular cancer is one of guarded optimism. Although some of these men are subfertile before the onset of their disease, it is probable that the majority, although temporarily subfertile because of their tumors, have a potential for normal fertility. Lymphadenectomy probably can be performed effectively while preserving ejaculation in most patients. Likewise, the effects of platinum-based chemotherapy appear to be reversible in many patients, and there is hope that spermatogenesis can be protected during chemotherapy by endocrine manipulation. During the next decade, the preservation of fertility will become an increasingly important issue in the management of testicular cancer as investigators consolidate therapeutic gains.