Objective: To assess the use rate and assisted reproductive technologies (ART) outcome of the cryopreserved semen of cancer patients with an average follow-up of 7 years (range, 2-23 years). Design: Retrospective data analysis. Setting: University-affiliated andrology and reproduction center. Patient(s): Six hundred twenty-nine male cancer patients who were referred for semen cryopreservation between 1983 and 2004. Intervention(s): Review of patient characteristics and ART outcome. Main Outcome Measure(s): Use rite and live births using cryopreserved semen. Result(s): A total of 749 semen samples from 557 men were preserved. Ninety-one patients died during follow-up, and another 29 requested disposal. Forty-two patients requested the use of their banked semen. ART data were available for 37 patients. A total of 101 ART cycles (32 IVF, 53 intracytoplasmic sperm injection [ICSIs], nine cryo-ET, and seven intrauterine inseminations [IUIs]) were performed, resulting in, respectively, 8, 16, 2, and I pregnancies. Pregnancies rates for IVF and ICSI were significantly higher than those for IUI. Conclusion(S): So far, 7.5% of the cancer survivors have used their banked semen, which led to live births in 49% of the couples. Semen cryopreservation is a reliable method to preserve fertility potential and gives couples a reasonable chance of achieving parenthood. (Fertil Steril (R) 2008;90:2245-50. (C) 2008 by American Society for Reproductive Medicine.)