**6. Fertility issue**

Studies have shown that fertility decreased after treatment in TC patients. In addition, treatment with chemotherapy and radiotherapy was reported to cause significant gonadal damage in men [64, 65].

In one study, half of the patients wanted to have children after TC treatment. However, according to the results of the study, fertility rate was lower after treatment than before treatment [66]. In the other study after treating for TC, 13 percent of patients developed hypogonadism [67]. Therefore, since the treatments to be applied to TC patients have a negative effect on fertility, solutions such as sperm banking, testicular tissue freezing, or removal of testicular sperm should be discussed with the patient before starting the treatment [68, 69].
