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Published on: March 4, 2018
Setting Up a Cryopreservation Programme for Immature Testicular Tissue: Lessons Learned After More Than 15 Years of
Aude Braye1, Herman Tournaye2, Ellen Goossens1
1Biology of the Testis (BITE), Department of Reproduction, Genetics and Regenerative Medicine (RGRG), Vrije Universiteit Brussel (VUB), Brussels, Belgium.
Abstract:
Young boys undergoing gonadotoxic treatments are at high risk of spermatogonial stem cell (SSC) loss and fertility problems later in life. Stem cell loss can also occur in specific genetic conditions, eg, Klinefelter syndrome (KS). Before puberty, these boys do not yet produce sperm. Hence, they cannot benefit from sperm banking. An emerging alternative is the freezing of testicular tissue aiming to preserve the SSCs for eventual autologous transplantation or in vitro maturation at adult age. Many fertility preservation programmes include cryopreservation of immature testicular tissue, although the restoration procedures are still under development. Until the end of 2018, the Universitair Ziekenhuis Brussel has frozen testicular tissues of 112 patients between 8 months and 18 years of age. Testicular tissue was removed in view of gonadotoxic cancer treatment (35%), gonadotoxic conditioning therapy for bone marrow transplantation (35%) or in boys diagnosed with KS (30%). So far, none of these boys had their testicular tissue transplanted back. This article summarizes our experience with cryopreservation of immature testicular tissue over the past 16 years (2002-2018) and describes the key issues for setting up a cryopreservation programme for immature testicular tissue as a means to safeguard the future fertility of boys at high risk of SSC loss.
Insights
Young boys at risk of infertility due to cancer treatments or genetic conditions can preserve future fertility by cryopreserving immature testicular tissue, safeguarding spermatogonial stem cells (SSCs) for later use.
Area of Science:
- Reproductive Medicine
- Oncology
- Pediatrics
Background:
- Gonadotoxic treatments and genetic conditions like Klinefelter syndrome (KS) risk spermatogonial stem cell (SSC) loss in prepubertal boys.
- Boys before puberty cannot bank sperm, necessitating alternative fertility preservation methods.
Purpose of the Study:
- To summarize the experience with cryopreservation of immature testicular tissue over 16 years.
- To describe key issues in establishing cryopreservation programs for boys at risk of SSC loss.
Main Methods:
- Retrospective analysis of testicular tissue cryopreservation data from 2002-2018.
- Inclusion of patients aged 8 months to 18 years undergoing cryopreservation for various medical reasons.
Main Results:
- 112 patients had testicular tissue cryopreserved by the end of 2018.
- Indications included gonadotoxic cancer treatment (35%), bone marrow transplantation conditioning (35%), and Klinefelter syndrome (30%).
Conclusions:
- Cryopreservation of immature testicular tissue is a viable strategy to preserve fertility in at-risk boys.
- Establishing such programs requires careful consideration of logistical and clinical factors for future SSC restoration.
