Abstract
While the incidence of cancer in children and adolescents has significantly increased over the last decades, improvements made in the field of cancer therapy have led to an increased life expectancy for childhood cancer survivors. However, the gonadotoxic effect of the treatments may lead to infertility. Although semen cryopreservation represents the most efficient and safe fertility preservation method for males producing sperm, it is not feasible for prepubertal boys. The development of an effective strategy based on the pharmacological protection of the germ cells and testicular function during gonadotoxic exposure is a non-invasive preventive approach that prepubertal boys could benefit from. However, the progress in this field is slow. Currently, cryopreservation of immature testicular tissue (ITT) containing spermatogonial stem cells is offered to prepubertal boys as an experimental fertility preservation strategy by a number of medical centers. Several in vitro and in vivo fertility restoration approaches based on the use of ITT have been developed so far with autotransplantation of ITT appearing more promising. In this review, we discuss the pharmacological approaches for fertility protection in prepubertal and adolescent boys and the fertility restoration approaches developed on the utilization of ITT.
Highlights
The Quest for Fertility Preservation and RestorationThe prevalence of cancer in children and adolescents (0–19 years of age) has increased by 27% over the last decades, while the likelihood to be diagnosed with cancer is higher in boys than in girls [1]
Oncofertility, a term introduced by Woodruff in 2007 [9], is an emerging cross-disciplinary field that involves a variety of fertility preservation strategies for patients diagnosed with cancer and who are at risk of becoming infertile due to the gonadotoxicity of the treatment
In the first part of this paper we review the current approaches on male gonadal protection and introduce a new promising approach based on the use of microRNAs, while in the second part we review the in vitro and in vivo experimental strategies developed based on the use of immature testicular tissue (ITT)
Summary
The prevalence of cancer in children and adolescents (0–19 years of age) has increased by 27% over the last decades, while the likelihood to be diagnosed with cancer is higher in boys than in girls [1]. The most commonly diagnosed types of cancer in prepubertal boys and adolescents are leukemia, brain and other central nervous system tumors, and lymphomas, whereas testicular germ cell tumors are frequently observed in adolescents [2]. For these patients, individual modern cancer treatment approaches can be lifesaving as indicated from the high (more than 80%) 5-year survival rate for childhood cancer patients [3,4,5]. In the first part of this paper we review the current approaches on male gonadal protection and introduce a new promising approach based on the use of microRNAs (miRNAs), while in the second part we review the in vitro and in vivo experimental strategies developed based on the use of ITT
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
