Fruitful progress to fertility: Male fertility in the test tube

Clark, Amander T.; Phillips, Bart; Orwig, Kyle E.

doi:10.1038/nm.2594

Cited by 26 publications

(30 citation statements)

References 15 publications

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“…These SSCs could then be autotransplanted back into the seminiferous tubules of the testicles to allow for spermatogenesis to resume. Reimplantation of expanded populations of SSCs has been demonstrated in animal models (Clark et al 2011;Sato et al 2011). Expansion of SSCs isolated from testicular tissue has also been preliminarily demonstrated in humans, though the data await replication (Sadri-Ardekani et al 2011;Wu et al 2009).…”

Section: State Of Basic Science Researchmentioning

confidence: 99%

“…The second line of research involves in vitro maturation of spermatogonia from SSCs for use in in vitro fertilization (Brinster 2007;Clark et al 2011). In vitro maturation of SSCs to sperm has been demonstrated in animal models but not yet in humans (Clark et al 2011;Sato et al 2011).…”

Section: State Of Basic Science Researchmentioning

confidence: 99%

“…Boys who do not bank their tissue may lose the opportunity to have biological children (Murphy 2010). Although TTCP is still in development, the technology has made steady gains, with proponents pointing to recent successes in animal models as evidence that human applications are not that far away (Clark et al 2011).…”

mentioning

confidence: 99%

“…Some commentators caution against sensationalism, arguing that questions of safety and feasibility should be at the forefront of any discussion of the procedure (Clark et al 2011). Since TTCP is a procedure with uncertain benefits and more than minimal risk (Clark et al 2011), restricting TTCP to IRB-approved research protocols may be the best method for protecting patients until further progress is made. It is possible that alternative techniques for maturing sperm from somatic cells will be developed, obviating the need for the procedure entirely (Clark et al 2011).…”

mentioning

confidence: 99%

“…Since TTCP is a procedure with uncertain benefits and more than minimal risk (Clark et al 2011), restricting TTCP to IRB-approved research protocols may be the best method for protecting patients until further progress is made. It is possible that alternative techniques for maturing sperm from somatic cells will be developed, obviating the need for the procedure entirely (Clark et al 2011). In addition, were TTCP to be expanded outside of research protocols, parents of cancer patients could be asked to share some of the costs of the procedure, which could place an additional burden on parents already in a state of emotional extremis (Ginsberg et al 2010).…”

mentioning

confidence: 99%

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Expanding Access to Testicular Tissue Cryopreservation: An Analysis by Analogy

Ruutiainen

Miller

Caplan

et al. 2013

The American Journal of Bioethics

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Researchers are developing a fertility preservation technique--testicular tissue cryopreservation (TTCP)--for prepubescent boys who may become infertile as a result of their cancer treatment. Although this technique is still in development, some researchers are calling for its widespread use. They argue that if boys do not bank their tissue now, they will be unable to benefit from any therapies that might be developed in the future. There are, however, risks involved with increasing access to an investigational procedure. This article examines four methods of expanding access to TTCP: (1) expansion of institutional review board (IRB)-approved research trials; (2) offering TTCP as an innovative procedure in hospitals; (3) offering TTCP as a standard practice in hospitals; and (4) commercialization of TTCP. The ethical and practical implications of each are evaluated through a comparison with umbilical cord blood banking (UCBB), a technology that has achieved widespread use based on similar claims of future benefit.

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Section: State Of Basic Science Researchmentioning

confidence: 99%

Section: State Of Basic Science Researchmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Expanding Access to Testicular Tissue Cryopreservation: An Analysis by Analogy

Ruutiainen

Miller

Caplan

et al. 2013

The American Journal of Bioethics

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Testicular tissue cryopreservation in prepubertal male children: An analysis of parental decision-making

Ginsberg

Carlson

et al. 2014

Pediatr Blood Cancer

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Background Infertility is an unfortunate treatment-related consequence for some pediatric malignancies as well as some non-malignant conditions treated with stem cell transplant. Unlike pubertal males, prepubertal males cannot produce semen for cryopreservation. This manuscript reports on the acceptability and safety of a multi-institutional protocol for offering testicular tissue cryopreservation to families of prepubertal male children at highest risk for infertility. Data on decision influences, decision-making control, and emotional state when considering this option are described. Procedure Prepubertal males facing gonadotoxic therapy were offered testicular cryopreservation. Post-biopsy, patients were followed for acute side effects. In addition, parents and patients were asked to complete questionnaires, whether or not they chose to cryopreserve tissue. Results Seventy-four prepubertal male children were approached. Fifty-seven families (77%) consented to the testicular biopsy; 48 of 57 underwent the procedure. There was one post-operative side effect. Parents who agreed to testicular cryopreservation and those that did not felt in control of this decision. Parents who consented to the biopsy and refusers were not deterred by the experimental nature of the protocol. An important decision-making influence was the risk of the biopsy. Conclusion Biopsy and cryopreservation of testicular tissue from prepubertal male children was performed successfully and safely at three institutions. Parents faced with this option at diagnosis can make an informed decision and weigh carefully the risks and benefits. Although asked to make a decision soon after they were given a difficult diagnosis, parents uniformly felt in control of this decision.

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Fertility Preservation in Cancer Patients

David

Orwig

2017

The Biology of Mammalian Spermatogonia

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Fruitful progress to fertility: Male fertility in the test tube

Cited by 26 publications

References 15 publications

Expanding Access to Testicular Tissue Cryopreservation: An Analysis by Analogy

Expanding Access to Testicular Tissue Cryopreservation: An Analysis by Analogy

Testicular tissue cryopreservation in prepubertal male children: An analysis of parental decision-making

Fertility Preservation in Cancer Patients

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