Fertility preservation options for prepubertal boys facing gonadotoxic therapies

Infertility is a common disease affecting 10-15% of reproductive couples with significant psychological and financial impacts to both patients and society. Approximately 80 million people worldwide are infertile, with an increasing incidence of male infertility. Semen cryopreservation in adults is a proven method of fertility preservation for male patients undergoing gonadal toxic therapies. Unlike adults who can cryopreserve sperm at any time prior to gonadal toxic treatments, there are no effective fertility preservation options for children undergoing cancer treatment, a time when semen cryopreservation is not feasible. Thus, most of the childhood cancer survivor will develop irreversible azoospermia due to the gonadal toxicity of the treatment on spermatogononial stem cells. This review will summarize the possible options and challenges of fertility preservation in this vulnerable population.