Testicular tissue freezing is an option for pre-pubescent patients who are not yet producing sperm. The tissue contains stem cells that will be able to start spermatogenesis (sperm production) in the future. Testicular tissue freezing is still considered experimental and is generally only offered in a research setting with oversight from an Institutional Review Board. Several studies are developing protocols that will enable scientists and physicians to use the frozen/thawed testicular tissue and stem cells to produce sperm in the laboratory or by re-implanting, years later, into the individual. Research has proven these strategies are effective in animals and it is envisioned that they will also soon be effective in humans.
Parents or legal guardians of pre-pubescent boys who have cancer or other diseases that may interfere with or destroy sperm production may choose testicular tissue freezing to protect their fertility. The tissue was cryogenically frozen and shipped to Reprotech for safe long-term storage. Several fertility centers in the U.S. and abroad are processing and freezing testicular tissue in anticipation that new stem cell-based therapies will be available in the future to help these patients achieve conception and have their own biological children.
The Fertility Preservation in Pittsburgh program at the University of Pittsburgh Medical Center (UPMC) has established a dedicated phone line (412-641-7475) and email address fertilitypreservation@upmc.edu that patients, their guardians, and their physicians may use to learn about the reproductive side effects of their treatments and options for preserving their fertility. This is a discussion that must take place before toxic therapies are initiated and fertility is irreversibly destroyed. There are no standard options to preserve the fertility of boys who are not yet producing sperm. For these young patients, The Fertility Preservation Program of Pittsburgh is approved to freeze testicular tissue that might be used in the future to restore fertility when experimental techniques emerge from the research pipeline. This experimental procedure is currently offered at the Children’s Hospital of Pittsburgh of UPMC, the Lurie Children’s Hospital of Chicago, Cincinnati Children’s Hospital, CHOC Children’s Hospital in Orange County, CA, the Children’s National Medical Center in Washington DC, Nationwide Children’s Hospital in Columbus, OH, and Washington University in St. Louis. Additional sites are preparing to participate in this multi-center study. For more information on standard and experimental options for preserving fertility please visit their website, email them at fertilitypreservation@upmc.edu, or call (412-641-7475).
A small portion (~25%) of the biopsy from each patient will be donated to research. This is necessary to allow research to happen and to develop the best methods to freeze, thaw, and use the testicular tissue. Experimental options that may be available in the future for patients who preserve testicular tissue are transplantation of spermatogonial stem cells (SSC) back into the testes of the patient; maturation of spermatozoa in testicular tissue organ culture and testicular tissue autografting or xenografting. It is important to note that except for SSC transplantation, all of these methods will require the use of IVF/ICSI to achieve fertilization and pregnancy. All testicular tissue-based fertility options are considered experimental and have not been fully translated to clinical practice.
