From puberty onwards, the testicles (the balls) begin to produce millions of sperm. The process of producing sperm is controlled by hormones. The sperm are stored in the testicles until they are released from the penis during ejaculation (‘coming’). They are released in a fluid called semen.

Some cancer treatments may damage the cells that produce sperm, so that no sperm is produced. It’s still possible to produce semen from the penis even if it doesn’t contain any sperm. So, some young men are still able to ejaculate even if they cannot fertilise an egg to create a baby.

A different hormone stimulates the testicles to produce the male hormone testosterone. Testosterone controls sex drive and affects the ability to get an erection (‘hard on’ or ‘stiffy’).

Some cancer treatments may reduce the production of testosterone by the testicles, which may mean that you have a low sex drive or that it is difficult or impossible to have an erection.

For a man to make a woman pregnant, sexual intercourse has to take place in which the man has an erection and ejaculates (releases) sperm into the vagina. If an egg is in the fallopian tube at the right time of the menstrual cycle, it can be fertilised by a sperm. The fertilised egg then buries itself in the lining of the womb and can grow to form a foetus and then become a baby.

For an erection to happen, the nerves and blood vessels in the penis and testicles need to be working normally. Surgery or radiotherapy in the pelvic area can sometimes damage the nerves and blood vessels that give an erection.
Diagram of a mans reproductive system

Diagram showing mens genitals. They are all in the lower half of the abdomen, with the testicles hanging level with the top of the leg within a sac called the scrotum. From the testicle is a tube called the spermatic cord this goes up and around behind the bladder and joins the urthra at the bottom of the bladder. The ejaculatory duct is at this join as well as the seminal vesicle. From the bladder the urethra then goes down through the penis. The penis contains erectile tissue.