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Published on: March 4, 2018
Freezing protocols for the cryopreservation of immature testicular tissue - a systematic review
1EGA Institute for Women's Health, University College London, London, United Kingdom.
Abstract:
Increasing numbers of childhood cancer survivors reach adulthood making therapy induced infertility a growing concern. Sperm cryopreservation is not possible prior to puberty. Testicular tissue cryopreservation has been proposed as an alternative fertility preservation method for prepubertal males but no standardised cryopreservation procedure for immature tissue has been agreed to date. Here we review the current literature of cryopreservation protocols to determine which method best preserves the morphology and function of immature testicular tissue; and to examine which tissue intervention, grafting or tissue culture, is mostly likely to restore fertility. Embase, Medline, and Web of Science were systematically searched using relevant MeSH headings and search terms for testis, cryopreservation, and fertility preservation. This systematic search returned 4748 unique entries which were screened for relevance. Eleven studies were found to be eligible and were included in the systematic review. We found that cryopreservation protocols differ in freezing rate and cryoprotectant media, the optimum combination of which for ITT has yet to be determined. Further investigations must be carried out to decipher which method best preserves tissue integrity and function and which application method is most likely to induce spermatogenesis.
Insights
Fertility preservation for prepubertal males facing cancer therapy is crucial. Testicular tissue cryopreservation shows promise, but optimal methods for preserving immature testicular tissue (ITT) and restoring fertility require further research.
Area of Science:
- Reproductive Medicine
- Oncology
- Cryobiology
Background:
- Cancer therapies can induce infertility in childhood cancer survivors.
- Sperm cryopreservation is not feasible before puberty.
- Immature testicular tissue cryopreservation is a potential fertility preservation strategy for prepubertal males.
Purpose of the Study:
- To systematically review cryopreservation protocols for immature testicular tissue (ITT).
- To determine the optimal method for preserving ITT morphology and function.
- To examine the efficacy of grafting versus tissue culture for restoring fertility.
Main Methods:
- Systematic literature search of Embase, Medline, and Web of Science.
- Inclusion of studies on testis, cryopreservation, and fertility preservation.
- Analysis of 11 eligible studies on ITT cryopreservation protocols.
Main Results:
- Significant variation exists in cryopreservation protocols, including freezing rates and cryoprotectant media.
- The optimal cryopreservation combination for ITT has not yet been established.
- Further research is needed to identify the best methods for preserving tissue integrity and function.
Conclusions:
- Standardized cryopreservation procedures for immature testicular tissue are lacking.
- Further investigation is required to determine the most effective cryopreservation techniques.
- The optimal approach for restoring fertility through tissue intervention (grafting or culture) needs further elucidation.
