Fathering a child after childhood cancer treatments

Joana B Serrano,Ans M M Van Pelt,Callista L Mulder,Andreas Meißner

doi:10.1007/s13629-022-00350-5

Abstract

AbstractAmong many deleterious ramifications of oncological treatments, there is permanent male infertility due to the damage to spermatogonial stem cells (SSC) in the testes after chemotherapy or irradiation. For those patients that cannot produce sperm before cancer treatment, because of prepubertal age, there are no clinical options available to father a child. To preserve fertility in childhood cancer patients, freezing of a testis biopsy is already offered before cancer treatment, while fertility treatment options using this biopsy are still under development, including spermatogonial stem cell transplantation (SSCT). SSCT requires isolation and in vitro propagation of spermatogonial stem cells from the cryopreserved biopsy, followed by autologous transplantation back to the adult cancer survivor. Given the implications of this potential stem cell therapy to recipients, their partners, and future offspring, we here aim to thoroughly appraise the state-of-the-art of SSCT focussing on safety for both patient and his future children.

Highlights

Fulfilling the desire for genetically related children in paediatric cancer survivors and those that have received stem cell therapy to cure benign haematological disease is hampered by the long-lasting effect of the gonadotoxicity of many treatments [1, 2]
The containing spermatogonial stem cells (SSC) enable long-term male fertility through a tight balance between self-renewal to maintain the pool of SSCs and differentiation into sperm
In the future, when in case of permanent infertility, the wish for genetically related children cannot be fulfilled by natural conception, a testis biopsy can be thawed

Summary

Introduction

Fulfilling the desire for genetically related children in paediatric cancer survivors and those that have received stem cell therapy to cure benign haematological disease is hampered by the long-lasting effect of the gonadotoxicity of many treatments [1, 2]. These toxicities should be addressed and managed by Artikel anticipating the solutions required to alleviate these late effects. With the improvement of cancer treatment and care, survival rates have increased steadily. There is an increasing group of paediatric cancer survivors that have equal desires as their age-peers for a family of their own

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Conclusion