Is Routine Pathology Evaluation of Tissue Removed for Fertility Preservation Necessary?

Area of Science:

• Reproductive Medicine
• Oncology
• Pediatric Endocrinology

Background:

• Fertility preservation (FP) involves biopsying gonadal tissue for pathology, a practice not universally adopted.
• This study evaluates the clinical utility of routine gonadal tissue biopsy in FP cases.

Purpose of the Study:

• To assess the value of routine pathology evaluation of ovarian and testicular specimens in fertility preservation cases.
• To determine the impact of biopsy findings on patient and family decisions regarding tissue storage.

Main Methods:

• Retrospective review of medical records for patients undergoing ovarian tissue cryopreservation (OTC) or testicular tissue cryopreservation (TTC) between 2011 and 2023.
• Data collected included patient demographics, diagnoses, operative details, and pathology results from gonadal tissue biopsies.

Main Results:

• 183 patients underwent OTC and 134 underwent TTC; all had gonadal tissue biopsied.
• Malignancy was found in 2.2% of OTC and 1.5% of TTC biopsies.
• Germ cells were not identified in 1.1% of OTC and 1.5% of TTC biopsies.
• All patients continued tissue storage after discussing pathology results.

Conclusions:

• Pathology results from gonadal tissue biopsies offer valuable information for fertility preservation decisions.
• While malignancy is rarely identified, its unexpected discovery can significantly alter diagnosis and treatment.
• Biopsy findings, including germ cell presence, aid in future fertility and hormone restoration planning.