What options for fertility preservation do pre-pubertal boys and girls have (in Croatia)?

Abstract

The latest progress in therapies indicated for the treatment of childhood cancers has enabled the improvement of survival rates in affected patients. However, the treatment can have gonadotoxic effects and sometimes results in infertility. Therefore, strategies for fertility preservation are developed for storage of intact reproductive tissue and possible future fertility restoration when the patient is cured of the initial disease. Currently, only the cryopreservation of immature reproductive tissue is well established. In contrast, the approach to restoring fertility using the stored tissue is, for now, in most cases, only theoretical, especially concerning pre-pubertal boys. On the other hand, fertility restoration in pre-pubertal girls is much more advanced, but further studies are needed to ensure safety regarding malignancies with a high risk of metastases. In order to overcome the risk of malignant contamination, when the cryopreserved reproductive tissue is intended to be applied (whether it is immature testicular or ovarian tissue), a suitable alternative to reproductive tissue autotransplantation is in vitro culture and development of mature gametes. For now, these methods are still in their onset and far from clinical application. Still, their advancement can be expected in the near future, given the rapid development of scientific techniques.