While the incidence of cancer in children and adolescents has significantly increased over the last decades, improvements made in the field of cancer therapy have led to an increased life expectancy for childhood cancer survivors. However, the gonadotoxic effect of the treatments may lead to infertility. Although semen cryopreservation represents the most efficient and safe fertility preservation method for males producing sperm, it is not feasible for prepubertal boys. The development of an effective strategy based on the pharmacological protection of the germ cells and testicular function during gonadotoxic exposure is a non-invasive preventive approach that prepubertal boys could benefit from. However, the progress in this field is slow. Currently, cryopreservation of immature testicular tissue (ITT) containing spermatogonial stem cells is offered to prepubertal boys as an experimental fertility preservation strategy by a number of medical centers. Several in vitro and in vivo fertility restoration approaches based on the use of ITT have been developed so far with autotransplantation of ITT appearing more promising. In this review, we discuss the pharmacological approaches for fertility protection in prepubertal and adolescent boys and the fertility restoration approaches developed on the utilization of ITT.
International journal of molecular sciences. 2019 Oct 21*** epublish ***
Elissavet Ntemou, Chrysanthi Alexandri, Pascale Lybaert, Ellen Goossens, Isabelle Demeestere
Research Laboratory in Human Reproduction, Faculty of Medicine, Université Libre de Bruxelles (ULB), B-1070 Brussels, Belgium. ., Research Laboratory in Human Reproduction, Faculty of Medicine, Université Libre de Bruxelles (ULB), B-1070 Brussels, Belgium. ., Laboratory of Physiology and Pharmacology, Faculty of Medicine, Université Libre de Bruxelles (ULB), B-1070 Brussels, Belgium. ., Biology of the Testis (BITE) Laboratory, Department of Reproduction, Genetics and Regenerative Medicine, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium. ., Research Laboratory in Human Reproduction, Faculty of Medicine, Université Libre de Bruxelles (ULB), B-1070 Brussels, Belgium. .