Testicular wedge biopsy for fertility preservation in children at significant risk for azoospermia after gonadotoxic therapy
jpedsurg.org shows its articles on its own site.
Read the article on jpedsurg.org ↗Article · Mar 2019 · 1 min read
In brief
In brief
Retrospective study of 23 pediatric patients demonstrates that testicular wedge biopsy for tissue cryopreservation is safe and feasible in children at high risk for treatment-induced infertility. The procedure can be coordinated with other surgeries without delaying cancer treatment, though fertility restoration from cryopreserved tissue remains experimental.
Written by the GCMD Library team from the article.
Background/purpose
Testicular tissue cryopreservation (TTC) provides an experimental option for fertility preservation for male children at significant risk for azoospermia owing to high-risk gonadotoxic treatments.
Methods
A single institution, retrospective review of TTC cases from 2015 to 2017. Children at significant risk for azoospermia were eligible for study inclusion. A unilateral wedge biopsy of the testis was performed for TTC.
Results
TTC was performed in 23 patients. Average age was 10 years old (5 months to 18 years). Diagnoses included solid tumor (74%, n = 17), hematologic malignancy (17%, n = 4), and benign hematologic disease (13%, n = 3). Six patients had TTC at the time of disease relapse. Nine patients were referred for TTC prior to stem cell transplantation. The majority (70%, n = 16) of patients had an additional procedure at the time of TTC. One patient developed postoperative scrotal cellulitis that was treated with antibiotics. The majority of patients (96%, n = 22) had normal testicular tissue with the presence of germ cells on histopathological analysis. Median time to start of medical therapy was seven days with no unanticipated treatment delays.
Conclusions
Testicular wedge biopsy for TTC can be performed safely, coordinated with other necessary procedures, and does not delay the start of treatment. TTC remains an experimental option for fertility preservation for children, as no spermatogenic recovery or pregnancies from cryopreserved testicular tissues have been reported to date.
Level of evidence
IV.