The increasing incidence of cancer among the reproductive population, especially Hodgkin's disease (HD) and testicular cancer, has been paralleled by a substantial improvement in survival rates. In addition to survival and recurrence rates, preserving future fertility and subsequent offspring welfare have become a main focus of modern treatment modalities and current extensive research. This article reviews contemporary data on the effects of cancer and cancer treatment on male fecundity. Gonadotoxicity of cytotoxic therapy will be discussed together with the current measures to preserve fertility. Finally, recent data on potential harm to future offspring of cancer survivors will be addressed.