Chapter 16 - Cryopreservation and transplantation of testicular tissue

Summary

Loss of fertility in adult life is a major psychologically traumatic consequence of cancer treatment. Improving therapeutic regimens using less gonadotoxic protocols could enable spontaneous recovery of spermatogenesis, but their use is not always possible without compromising patient survival. Cryopreservation of testicular tissue pieces may be considered as an alternative method capable of maintaining cell-to-cell contacts between Sertoli and germinal stem cells, and therefore preserving the stem cell niche necessary for their survival and subsequent maturation. In humans, preclinical in vitro studies using cadaver or surgically removed testes have demonstrated the feasibility of transplanting germ cell suspensions into testes. The first convincing demonstration of human testis transplantation was reported in 1978. The most important, life-threatening concern of spermatogonial transplantation is the risk of reintroducing malignant cells. Providing young people undergoing gonadotoxic treatment with adequate fertility preservation strategies is a challenging area of reproductive medicine.