Recent advances in the treatment of cancer have led to greater longevity among men in reproductive ages with a 75% five-year cancer survival rate in boys aged 15 years or younger [1] and 66% among men aged 15–44 [2]. There is increased recognition that quality of life including paternity is significant issues for cancer survivors. We will focus primarily on patients with testicular cancer and lymphoma that generally affects younger patients in the reproductive window with an excellent overall survival. However, one must realize in our modern society the age of desiring paternity has increased due to postponement of marriage as well as for other social reasons. Therefore, this chapter will focus not only on those who completed chemotherapy as children but adult cancer patients as well.

The interplay between psychological and ethical issues continues to shape and define the role and responsibilities of professionals in the field of ART. Advances in ART have brought the process of creating a child some distance from nature, enabling physicians to offer patients a variety of permutations in terms of conceiving and carrying offspring. Women can be stimulated to produce multiple oocytes, resulting in multiple births that would not otherwise have occurred. Patients can receive donor gametes – eggs and/or sperm or embryos – to create children who (from a genetic point of view) would not otherwise have been created and whose genetic makeup does not reflect their own.