Approaches and Technologies in Male Fertility Preservation

Abstract

Male fertility preservation is required when treatment with an aggressive chemo-/-radiotherapy, which may lead to irreversible sterility. Due to new and efficient protocols of cancer treatments, surviving rates are more than 80%. Thus, these patients are looking forward to family life and fathering their own biological children after treatments. Whereas adult men can cryopreserve their sperm for future use in assistance reproductive technologies (ART), this is not an option in prepubertal boys who cannot produce sperm at this age. In this review, we summarize the different technologies for male fertility preservation with emphasize on prepubertal, which have already been examined and/or demonstrated in vivo and/or in vitro using animal models and, in some cases, using human tissues. We discuss the limitation of these technologies for use in human fertility preservation. This update review can assist physicians and patients who are scheduled for aggressive chemo-/radiotherapy, specifically prepubertal males and their parents who need to know about the risks of the treatment on their future fertility and the possible present option of fertility preservation.

A Novel Organoid Model of In Vitro Spermatogenesis Using Human Induced Pluripotent Stem Cells

“…Cancer treatments are often gonadotoxic, therefore pre-pubertal patients are given the option of banking their pre-treatment testis tissues [73,74] however maturing these tissues to generate spermatozoa for in vitro fertilization (IVF) therapies remains in the experimental stages, and is currently dependent upon extremely rare pre-pubertal testicular tissues with which to establish in vitro culture systems. [75][76][77] hiPSC-derived testicular organoids could serve as a suitable alternative resource to optimize such in vitro systems until larger banks of pre-pubertal tissues are available to researchers.…”

Sperm Selection Procedures for Optimizing the Outcome of ICSI in Patients with NOA

“…Thus, cryostored tissue samples can be used for future testicular grafting or organ culture procedures as well as for testicular transplantation or in vitro maturation with germ cells isolated from the tissue. At the same time, the niche microenvironment formed by Sertoli, Leydig, peritubular, and somatic cells in the preserved testicular tissue allows germ cells to maintain their viability and function after thawing [ 152 , 153 ]. On the other hand, cryopreservation of homogenized isolated spermatogenic cell fractions has been shown to preserve cell viability more than whole testicular extracts [ 154 ].…”

“…Chromosomal aneuploidy is more likely to be encountered in testicular sperm from patients with NOA [ 211 , 212 ]. Moreover, cryopreservation of testicular cells or tissues poses the risk of the presence of residual cancer cells during the transplantation of autologous cells in patients scheduled for oncotherapy, which may trigger the disease [ 153 ]. However, the absence of such a risk, at least in experimental studies, has been demonstrated by the lack of increase in cancer incidence or survival reduction after testicular transplantation of propagated spermatogonial stem cells (SSCs) [ 213 ].…”

Recent Microfluidic Innovations for Sperm Sorting

“…In vivo, the mammalian spermatozoa undergo an intense process during their migration through the female reproductive tract [19]. The passage of sperm through this tract is therefore regulated to ensure only sperms with normal morphology and vital motility will succeed [20,21].…”