Experience and andrological follow-up after testicular tissue cryopreservation

Abstract

Research Question: What is the experience, mid- and long-term andrological health follow-up in (pre)pubertal males who have undergone testicular tissue freezing (TTF)?Design: This is a single-centre longitudinal retrospective cohort study that reports on the mid- and long-term andrological health follow-up of (pre)pubertal males and young adults who have undergone TTF for fertility preservation between January 2007 and December 2018. Medical characteristics and questionnaire data collected more than 18 months after TTF were analysed.Result: 36 patients were revisited during a medical follow-up consultation. During follow-up after TTF, about 73% of patients could not recollect their counselling consultation prior to TTF but 42.4% of them found information about the TTF process useful and sufficient. Parents’ or legal guardians’ feedback was more positive about the counselling consultation and the TTF process. After TTF and treatment, the majority of patients (76.9%) who provided a semen sample had non-obstructive azoospermia. Higher serum levels of FSH and LH and lower serum levels of inhibin B were associated with non-obstructive azoospermia (P = 0.0121; P = 0.0182; P = 0.0045 respectively). During cancer treatment, about half of pubertal patients reported sexual dysfunction, decreasing to approximately 20% after treatment. However, two patients had children using sperm donation and one patient had a child through natural pregnancy.Conclusions: Parental or legal guardians’ involvement is crucial in the decision-making process for fertility preservation in (pre)pubertal boys. Regular follow-up, including the use of questionnaires, is essential to provide guidance for FP programs and information on fertility restoration options and to address the psychosocial aspects of fertility preservation.