Testicular tissue samples obtained from 189 males who were facing procedures that could imperil fertility were cryopreserved at one university, proving the feasibility of centralized processing and freezing of testicular tissue obtained from academic medical centers, including Children’s National, scatter around the world.
Fertility preservation options
An estimate 2,000 U.S. boys and young men each year receive treatments or have cancers or blood disorders; so that place them at risk for infertility. While older youths who have undergone puberty can bank their sperm prior; so to undergoing sterilizing doses of chemotherapy or radiation; so there have scant fertility preservation options for younger boys. However, some older adolescents and young men are too sick or stress to bank sperm.
For patients with no sperm to bank or who are too sick or stress to bank sperm; so the experimental procedure of freezing testicular tissue in anticipation that future cell or tissue base therapies can generate sperm is the only option. Recent research in experimental models indicates that such testicular tissue; so biopsies contain stem cells, blank slate cells, hinting at the potential of generating sperm from biopsie tissue.
This study demonstrates that undifferentiate stem and progenitor spermatogonia; hence may be recover from the testicular tissues of patients who are in the early stages of their treatment and have not yet receive an ablative dose of therapy. The function of these spermatogonia was not tested,” writes lead author Hanna Valli-Pulaski, Ph.D., research assistant professor at the University of Pittsburgh, and colleagues in a study publish online May 21, 2019, in Human Reproduction.
Future treatment options
Right now, hematologists and oncologists discuss future treatment options with patients and families; so as well as possible long-term side effects, including infertility. At Children’s National, they also mention the ongoing fertility preservation study and encourage families to speak with Dr. Hsieh.
This study is unique in that there is definitely a potential direct patient benefit,” Dr. Hsieh adds. One of the reasons the study is compelling is that it presents a message of hope to the families. It’s a message of survivorship: They’re optimistic we can help your child get through this and think about long-term issues, like having their own families.
In this phase of the study, testicular tissue was collect from centers in the U.S. and Israel from January 2011 to November 2018 and cryopreserv. Patients designate 25% of the tissue sample to be use for the research study; 75% remains store in liquid nitrogen at temperatures close to absolute zero for the patient’s future use. The fertility preservation patients range from 5 months old to 34 years old, with an average age of 7.9 years.
They recommend that all patients be counseled and refer for fertility preservation before beginning medical treatments known to cause infertility. Because the decision to participate may be delayed, it is encouraging that we were able to recover undifferentiate spermatogonia from the testes of patients already in the early stages of chemotherapy treatments,” Dr. Hsieh says.