Fertility preservation in boys treated for cancer: evaluating the impact of harvesting testicular tissue at young age on the later pubertal development and fertility (prospective study)

The number of childhood cancer survivors has increased thanks toadvances in cancer treatment. Although for long it was assumed thatchildren were more resistant to cancer treatment, now, there isenough evidence that they are also at risk for lifelong sterility. Sincespermatogenesis only starts at puberty, prepubertal boys cannotbenefit from sperm banking before treatment. Because the progenitorcells (spermatogonial stem cells) are present in the testes since birth,banking of testicular tissue may prevent later sterility in boys exposedto cancer treatment. Our research group has performed pioneeringwork concerning the development of fertility preservation strategiesand translation towards the clinic. Since 2002, the UZ Brussel storedtesticular tissue from >100 boys. Some of these patients have beenfollowed by an oncologist and endocrinologist. A retrospective studydemonstrated that this follow-up was far from standardized withirregular consultations and plenty of missing data. Therefore, strongconclusions on the effect of a testicular biopsy at young age on thelater pubertal development and fertility could not be drawn. However,these data allowed to improve the follow-up protocol.Now, we aim to use this new follow-up protocol in a prospective studyto evaluate the impact of harvesting testicular tissue at young age onthe later pubertal development and on fertility at adult age. This willallow further improvement of fertility preservation strategies.