Male infertility is a complex and incompletely understood process that is thought to affect around 10% of the male population. Infertility is a complex interaction between genetics and environmental factors, which is increasingly being recognized as a potential marker of contemporary or future medical disease, including cancer. The best characterized association between infertility and cancer risk is that of testicular germ cell tumor, but increased risk for prostate cancer, melanoma, non-Hodgkin's lymphoma, and others have also been described. Much like infertility, the mechanism behind these associations is not completely understood. Several hypotheses have been put forth including testicular dysgenesis syndrome, chromosomal abnormalities, damaged DNA repair mechanisms, or Y chromosome abnormalities. With the use of advance reproductive techniques, more men are bypassing a male fertility specialist who may be positioned to diagnose or counsel patients regarding these risks.