Fertility Preservation in the Pediatric Cancer Patient

Richard N. Yu


Curr Opin Urol. 2019;29(5):477-480. 

In This Article

Prepubertal Tissue Cryopreservation

The only fertility preservation options for prepubertal men involve cryopreservation of testicular tissue or dissociated testicular cells (cell suspension). For prepubertal patients that elect to fertility preserve, testicular biopsy under general anesthesia is required to obtain the specimen. The procedure is often coordinated with other oncology-related procedures, such as central line placement, lumbar puncture, or bone marrow biopsy. In general, testicular biopsy is a relatively low-risk procedure but complications such as epididymo-orchitis or cellulitis have recently been reported.[13–15] In a recent report from the Netherlands, testicular biopsy does not appear to affect testicular growth but may result in intra-testicular scarring in 6% of patients.[13] There is also evidence to suggest that spermatogonial stem cell quantity is significantly reduced in testes of prepubertal boys treated with alkylating agents prior to biopsy.[16] Therefore, prepubertal preservation should ideally be performed prior to initiation of cancer treatment similar to the recommendations for AYA patients.