Fertility Preservation in the Pediatric Cancer Patient

Richard N. Yu


Curr Opin Urol. 2019;29(5):477-480. 

In This Article

Prepubertal Tissue Preservation Research

Prepubertal testicular tissue preservation remains investigational as there are no clinical studies to date demonstrating the utility of this tissue for restoration of spermatogenesis or, more importantly, for procreation. Although, multiple research studies using animal models have demonstrated the remarkable potential of spermatogonial stem cells in restoring fertility in animals sterilized using chemotherapeutic agents.[17,18] Studies with the closest relevance to humans in terms of anatomy and physiology have been performed using rhesus (Rh) macaques. Two recent studies have highlighted the potential for preserved prepubertal testicular tissue in restoring fertility. The study from Shetty et al.[19] showed that cryopreserved prepubertal testicular cells can be transplanted in an allogeneic manner to immunosuppressed adult recipients and result in de novo seminiferous tubule formation. Furthermore, the same research group utilized an experimental design with many parallels to prepubertal cancer patents.[20] Prepubertal testicular tissue from Rh macaques were cryopreserved. After the animals reached puberty, the cryopreserved tissue was then autologously grafted underneath the skin of each donor monkey. Complete spermatogenesis was found in all grafted tissue and were sufficient to fertilize Rh oocytes. They were also able to obtain a live healthy baby after transfer of blastocyst stage embryos into recipient women.