Male cancer survivors in Uruguay who froze their sperm between 1985 and 2021 were surveyed to assess their fertility status and the counseling they received. The study found that 68% of survivors who tried to conceive naturally were successful, while 45.4% of those who used their cryopreserved samples achieved pregnancy. Most survivors believed that the timing of fertility preservation referrals was appropriate and considered protecting their fertility very important. The majority of survivors viewed fertility preservation positively, regardless of their reproductive outcomes, highlighting the importance of counseling for young cancer patients' future quality of life.