Childhood Cancer and Fertility Options for Young Men
Many men who survived childhood cancer would like to start families of their own, but cancer treatment can take a toll on their fertility.
Fortunately, they may have options. The journal Current Opinion in Urology recently published a review of fertility preservation studies, focusing on male childhood cancer survivors. Adolescents and young adults may bank their sperm before cancer treatment. The cells can then be frozen and stored for in vitro fertilization (IVF) later. Options for prepubescent boys are more limited. Scientists are experimenting with the preservation of testicular tissue before cancer treatment.
More childhood cancer patients are surviving into adulthood nowadays, and many of those patients would like to start families. Scientists have been exploring ways to preserve fertility before cancer treatment starts.
A recent paper in Current Opinion in Urology discusses some of the options for boys. Some methods are available now, while others are in the experimental stages.
Dr. Richard N. Yu of Boston Children’s Hospital examined articles published between January 2017 and April 2019 for this review.
Doctors and families should discuss fertility preservation before treatment begins, as sperm cells can be damaged during therapy, Dr. Yu said.
Sperm preservation is an option.
For adolescents and young adults, sperm banking is the “gold standard” option. Sperm cells may be collected through masturbation or removed from testicular tissue in a sperm extraction procedure. Testicular biopsy and electro-ejaculation (ejaculation with the help of electrical stimulation) are other methods.
Once the sperm is obtained, it can be cryopreserved – carefully frozen and stored so that the cells can be used to create embryos at a later time.
Options for boys who have not yet reached puberty are more limited. For these patients, testicular tissue or cells may be removed in a biopsy procedure and be cryopreserved. This surgery might be combined with other cancer-treating surgeries.
However, preserving testicular tissue from prepubertal boys is still in the experimental stages, and there have been no clinical studies on its effectiveness in humans. But some animal studies have had encouraging results. For example, scientists have collected testicular tissue from prepubertal rhesus macaques (a type of monkey that is anatomically similar to humans), frozen it for later use, fertilized egg cells, and created a healthy baby monkey.
Further research is needed in this area, Dr. Yu noted. He added that there can be ethical concerns with this type of preservation and that the advantages and disadvantages must be carefully considered.
For more information about cancer and fertility, please see these links:
Current Opinion in Urology via Medscape
Yu, Richard N.
“Fertility Preservation in the Pediatric Cancer Patient”
(Full-text. September 2019)