Fertility Preservation in Pre-Pubertal and Pubertal Cancer Male Patients

Abstract

Introduction. Ex juvantibus confirms that anticancer therapies involving highly toxic agents adversely impact reproductive function. Treatments for childhood malignancies carry equally significant gonadotoxic long-term effects. Current fertility preservation techniques for children and adolescents, particularly the widely used cryopreservation of mature oocytes (in girls) and sperm (in boys), remain unfeasible prior to puberty. In males, sperm cryopreservation represents the most common preservation method. For prepubertal boys, testicular tissue cryopreservation serves multiple purposes: assessing short- and long-term testicular biopsy complications; evaluating the effects of gonadotoxic treatments on future reproductive capacity; refining patient selection criteria through ongoing fertility risk stratification based on diagnosis and treatment protocols; and updating patients and families about scientific advances enabling potential future tissue utilization.

Materials and Methods. The clinical study protocol was developed at the N.N. Petrov National Medical Research Center of Oncology (Ministry of Health, Russia) and approved by the Local Ethics Committee (Protocol No. 18, March 21, 2023). This single-center study focuses on fertility preservation in prepubertal and pubertal boys aged under 17 years with cancer diagnoses.

Conclusion. Current fertility preservation methods for prepubertal boys remain experimental without established standards. Our study pursues the objective to establish a biological cryobank, to refine techniques for spermatogonial stem cell isolation, cultivation and cryopreservation to restore spermatogenesis, and to evaluate the safety of testicular incisional biopsy in this population.