To optimize fertility preservation management in unilateral or bilateral testicular cancer.Case series.Urology department and reproductive biology laboratory.Dizygotic azoospermic twins presenting unilateral and bilateral synchronous testicular tumors.Testicular sperm extraction (TESE) and orchiectomy.Semen analysis, histologic diagnosis.No spermatozoa were cryopreserved for the first case, because fertility preservation was proposed after orchiectomy. Spermatozoa were retrieved after TESE for his brother with bilateral tumor.Clinicians should be aware of the need to recommend sperm banking before treatments may alter spermatogenesis. TESE may be the sole option for fertility preservation in bilateral testicular cancer.