The impact of cancer on male fertility may precede chemotherapy, or radiation treatment. While the reasons are not clearly understood, male sperm count may be reduced by the cancer itself. This makes male fertility for all cancer patients a matter of concern at the time of diagnosis.
For post-pubertal boys, the most common form of fertility preservation is cryo-preservation of sperm. Even patients with low sperm count can take advantage of cryo-preservation to bank sperm indefinitely. Additionally, surgical procedures can be used to extract sperm from the mature testes for cryo-preservation. Of all the protocols in place for the preservation of fertility, those available to the post-pubertal boys are the most widely used and have the longest success record. While the discussion of sensitive matters is always difficult for adolescent boys and their parents, the confidence that comes with years of successful sperm preservation should make the conversation hopeful.
It is unclear at what stage of maturation a young boy is able to produce sperm. However, sperm production in young boys is not possible. Researchers are currently using a surgical technique to remove immature testicular tissue for cryo-preservation. Because of the power of immature cells to form new cells, researchers hold hope for creating sperm from immature tissue. The cryo-preservation of undeveloped testes is currently available in a limited number of hospitals in the United States. At this time the following physicians are accepting patients for this research study:
Ann & Robert H. Lurie Children’s Hospital of Chicago
Barbara Lockart, DNP, APN/CNP – firstname.lastname@example.org – (312) 227-4901
Children’s Hospital of Pittsburgh
Katherin Gassei — email@example.com
Julie Seifert — firstname.lastname@example.org
Fertility Preservation Phone Line — (412) 641-7475
Children’s National Medical Center, DC
Kelsey Hilton — KelseyKHilton@childrensnational.org
Amanda Mahoney — AMahoney@childrensnational.org
Children’s Hospital of Orange County and UC-Irvine
Julie Messina — email@example.com
The cryo-preservation of testicular cells and their future development into fertility enabling tissue is experimental. However, it may well be a reality within the lifetime of the young cancer survivor.
A course entitled “Male Oncofertility: Advocating Your Patients’ Fertile Future,” by Alice Crisci is available free of charge at www.udemy.com. You must register for a free account to watch the following recommended segments:
- Film 1: “Gravity of Cancer” – for all parents
- Film 2: “Post Pubertal Fertility Preservation” – for adolescent patients and their parents
- Film 3: “Sperm Extraction” – for adolescent patients and their parents
- Film 4: “Testicular Tissue Freezing” — for pre-pubertal patient’s parents
- Film 5: “Handling the Conversation” – primarily for medical providers
- Film 6: “Path to Parenthood” – for all viewers
This course was designed for medical personnel. However, PORF recommends it for parents and older patients. The films are short and easily understood by any population.
The cryopreservation of testicular tissue remains experimental for pediatric cancer patients.. For this reason, parents who choose to have their child’s tissue preserved must enroll him in a research study. This study holds great hope for the use of cryo-preserved tissue for normal hormone health, as well as eventual pregnancy. The following hospitals are part of the Oncofertility Research Consortium and are fully prepared to enroll children in this study. The contact person at each hospital can be contacted by the treating oncologist, or directly by parents.
PORF encourages parents to learn more about fertility preservation before making a final decision. The RESEARCH section of the website gives an overview of current research relevant to pediatric patients. The PREPARE section suggests questions that parents may pose to medical care providers and to each other. The CONNECT section shows parents how to best connect to the closest medical facility that participates in Pediatric Oncofertility Research. This section also connects parents with others who have made fertility preservation decisions before them.