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This chapter focuses on patients with testicular cancer and lymphoma that generally affects younger patients in the reproductive window with an excellent overall survival. The chance of recovery of spermatogenesis depends on the chemotherapeutic regimen as well as the baseline function of the patient. The existence of a previously cryopreserved sperm greatly simplifies the algorithm for the post chemotherapeutic azoospermic man and, essentially, the couple can go directly to in vitro fertilization (IVF). Azoospermia after chemotherapy can be due to the patient's chemotherapeutic regimen, the use of radiation, the extent of surgery, the disease itself, the baseline function of the patient or any combination of the aforementioned factors. Additional counseling is recommended for those patients who choose the assistance of third-party reproduction. Gamete donation has made it possible for participants to cross generational lines and has raised many complicated ethical issues.