Pediatric fertility preservation: is it time to offer testicular tissue cryopreservation?
As the effectiveness of cancer treatments has improved, children diagnosed with cancer can enjoy a longer life free of the disease. However, chemotherapeutic regimens alone or in combination with radiation therapy frequently result in azoospermia or infertility. This paper reviews currently and potentially available methods to maintain fertility in boys undergoing chemotherapy or radiation therapy. Whenever possible, chemotherapeutic agents that are less likely to cause azoospermia, should be considered. Hormonal suppression applied prior to and during chemotherapy may protect future male fertility. Cryopreservation of sperm enables men to reproduce in the future. New techniques, such as in vitro fertilization with intra-cytoplasmic sperm injection offer a more promising future for male cancer sufferers. These techniques however, are not applicable to pre-puberty cancer patients. The use of spermatogonial and embryonic stem cells open new possibilities for boys diagnosed with cancer.
Revel
Ariel
A
Department of Obstetrics and Gynecology, Hadassah Medical Center and Hebrew University-Hadassah Medical School, Jerusalem, Israel. arielr2@hadassah.org.il
Revel-Vilk
Shoshana
S
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015925:Cryopreservation / Q000379:methods*; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D011878:Radiotherapy / Q000009:adverse effects; D012662:Semen Preservation / Q000379:methods; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D013737:Testis