Spermatogonial Stem Cell Isolation, Storage, and Transplantation

Abstract

The past 30 years have been marked by unparalleled accomplishments in the medical treatment of malignancy. Prior to advances in chemotherapeutic and radiation treatment, many oncologic conditions had dismal survival rates. Today, medical interventions have success rates that approach complete remission for many malignancies. An inadvertent complication of these therapies, however, has been the high rate of infertility following treatment. Male germinal tissue, like many malignancies, is mitotically active and therefore is particularly susceptible to the toxic effects of both chemotherapy and radiotherapy (Meistrich et al, 1982; Meistrich, 1993). Consequently, posttreatment patients often develop severe oligozoospermia or azoospermia (Wallace et al, 1991). Potential infertility complications can be anticipated, and adult male patients interested in future procreation are counseled to cryopreserve semen before instituting treatment. With presentday capabilities of in vitro fertilization, particularly intracytoplasmic injection, male patients can maintain posttreatment fertility. Pretreatment sperm banking, however, is not a viable option for prepubescent males. These individuals have not yet begun spermatogenesis and thus lack viable spermatozoa. It is estimated that, by the end of the decade, 1 in 250 young men will be childhood cancer survivors (Blatt, 1999). For these patients, infertility has often been an accepted consequence of their lifesaving treatment.