A New Strategy and System for the Ex-Vivo Testicle Perfusion and Cryopreservation

Mohamed Sa Mohamed

doi:10.21767/2172-0479.1000108

Abstract

Childern, who suffer from cancer, receive gonadotoxic therapy, which destroys their future fertile abilities after survival. Testicular cryopreservation and transplantation provides the promising solution to this problem, where the testicle can be removed before the gonadotoxic therapy and reimplanted after patient's survival, where the testicle is to be cryopreserved during the period of the therapy. However, the effective cryopreservation of the whole testicle can be obstacle by the ischemic reperfusion injury and the defective cryopreservation related to the defective ability to universally deliver the cryopreservation/warming solutions through the organ vascular bed. To overcome those obstacles, an innovative system is suggested to insure immediate and universal delivery of the cryopreservation/warming solutions to the graft, in addition to keep the graft under continuous perfusion before and after cryopreservation, minimizing any chance for microthrombi formation or ischemia-reperfusion.

Highlights

Testicular cryopreservation aims at the preservation of fertility in children and prepubertal boys, subjected to gonadotoxic anti-cancer therapy, hematopoietic stem cells transplantation and other reasons of intensive chemotherapy
Testicular cryopreservation can be performed using the slow freezing technique, where a programmable controlled temperature change can be applied, or the Vitrification technique, where the testicular tissue is equilibrated with suitable concentrations of cryoprotectants and directly plunged into liquid nitrogen [3,4]
The technique of cryopreservation has been tried with animals and humans, applying both slow freezing and Vitrification techniques, with the results of Vitrification are comparable to those of slow freezing [5,6]

Summary

Introduction

Testicular cryopreservation aims at the preservation of fertility in children and prepubertal boys, subjected to gonadotoxic anti-cancer therapy, hematopoietic stem cells transplantation and other reasons of intensive chemotherapy. Further indications could differ from country to another, based on the available medical regulations [1,2]. Testicular cryopreservation can be performed using the slow freezing technique, where a programmable controlled temperature change can be applied, or the Vitrification technique, where the testicular tissue is equilibrated with suitable concentrations of cryoprotectants and directly plunged into liquid nitrogen [3,4]. The technique of cryopreservation has been tried with animals and humans, applying both slow freezing and Vitrification techniques, with the results of Vitrification are comparable to those of slow freezing [5,6]

Ex Vivo Testicle Perfusion

The Expected Advantage

Sertoli Cells

Conflicts of Interest