testicular tissue cryopreservation for fertility preservation

Conditions: Cancer; Autoimmune Disorders

Summary: testicular tissue cryopreservation is an experimental procedure where a young boy's testicular tissue is retrieved and frozen. this technique is reserved for young male patients who are not yet producing mature sperm, with the ultimate goal that their tissue may be used in the future to restore fertility when experimental techniques emerge from the research pipeline.

fertility status has an important impact on the post-treatment quality of life for cancer survivors and other patients that receive gonadotoxic therapies (e.g., prior to bone marrow transplantation). semen cryopreservation is an established fertility preserving therapy, but is not accessible or appropriate for all men. currently there are no therapies to preserve the future fertility of preadolescent boys. however, new reproductive therapies are under development and may one day offer "fertile hope" to those survivors that do not currently have access to fertility preserving therapies. clinical management of fertility threatening diseases and treatments must have foresight of the gonadotoxic side effects and the potential for infertility. when no established fertility sparing options are available, it is reasonable to offer harvesting and cryopreservation of testicular tissue as a possible means of fertility preservation. this study will harvest testicular tissue from eligible patients. separate portions of the harvested tissue and/or cells will be 1) designated for research and 2) cryopreserved and maintained for participating patients as a resource for future elective procedures to attempt fertility restoration.

Eligibility criteria:
inclusion criteria: * be male at any age. * be scheduled to undergo surgery, chemotherapy, drug treatment and/or radiation for the treatment or prevention of a medical condition or malignancy with risk of causing permanent and complete loss of subsequent testicular function. * or, have a medical condition or malignancy that requires removal of all or part of one or both testicles. * have newly diagnosed or recurrent disease. those who were not enrolled at the time of initial diagnosis (i.e., patients with recurrent disease) are eligible if they have not previously received therapy that is viewed as likely to result in complete and permanent loss of testicular function. * have two testicles if undergoing elective removal of all or part of a testicle for fertility preservation only. note: removal of both testicles will limit fertility preservation options. * sign an approved informed consent and authorization permitting the release of personal health information. the patient and/or the patient's legally authorized guardian must acknowledge in writing that consent for specimen collection has been obtained, in accordance with institutional policies approved by the u.s. department of health and * consent for serum screening tests for infectious diseases \[hiv-1, hiv-2, hepatitis b, hepatitis c\], to be performed at the time of testicular tissue harvesting. * undergo a full history and physical examination and obtain standard pre-operative clearance (based on the most recent acc/aha guideline for perioperative cardiovascular evaluation for noncardiac surgery) as determined by their primary surgeon. * participating in long term follow-up is a requirement of the protocol. exclusion criteria: * diagnosed with psychological, psychiatric, or other conditions which prevent giving fully informed consent. * diagnosed with an underlying medical condition that significantly increases their risk of complications from anesthesia and surgery.

Keywords: spermatogonial stem cells testis fertility infertility oncofertility