Update on fertility restoration from prepubertal spermatogonial stem cells: How far are we from clinical practice?
Fertility preservation in prepubertal boys facing gonadotoxic treatment is still at the experimental stage. Nevertheless cryopreservation of immature testicular tissue (ITT) obtained by small testicular biopsy is being increasingly proposed in reproductive care clinics for this purpose. Different approaches to in vivo or in vitro mature spermatogonial stem cells (SSCs) contained in ITT have been studied: autografting of testicular tissue pieces, transplantation of one's own purified germ cell suspensions, and in vitro maturation (IVM) for subsequent use of sperm for intra cytoplasmic sperm injection (ICSI). While complete spermatogenesis yielding fertile offspring has been achieved in a number of animal species after cell and tissue transplantation and IVM, no mature sperm has yet been obtained from human prepubertal SSCs. This review describes research conducted by our team and a number of others working on fertility restoration from SSCs, with special emphasis on debated concerns and progress made towards clinical application of different strategies.
Department of Gynecology-Andrology, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium.
Maria Grazia
MG
Giudice
Department of Gynecology-Andrology, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium; Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Avenue Mounier 52, 1200 Brussels, Belgium.
Francesca
F
de Michele
Department of Gynecology-Andrology, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium.
Jonathan
J
Poels
Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Avenue Mounier 52, 1200 Brussels, Belgium.
Maxime
M
Vermeulen
Department of Gynecology-Andrology, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium; Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Avenue Mounier 52, 1200 Brussels, Belgium. Electronic address: christine.wyns@uclouvain.be.
Christine
C
Wyns
D002986:Clinical Trials as Topic; D059247:Fertility Preservation; D006801:Humans; D008297:Male; D011627:Puberty / Q000502:physiology*; D013093:Spermatogonia / Q000166:cytology*; D013234:Stem Cells / Q000166:cytology*; D013737:Testis / Q000166:cytology / Q000637:transplantation