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For Young Boys With Cancer, Testicular Tissue Banking May Be Option to Preserve Fertility
Date:11/9/2009

llaborators is Ralph L. Brinster, V.M.D., Ph.D., Richard King Mellon professor of Reproductive Physiology at the University of Pennsylvania School of Veterinary Medicine, an internationally renowned expert in genetics and reproduction.

Starting in January 2008, a multidisciplinary team at Children's Hospital approached the families of 21 boys, ranging from three months old to age 14, who had been just diagnosed with various solid tumors. All faced the imminent prospect of treatments with chemotherapy or radiation that carried a significant risk of male infertility.

Of the 21 families approached, 16 consented to the biopsy as part of the research study, an acceptance rate of 76 percent. Fourteen of the 16 underwent the procedure.

In the procedure, performed at the same time the child was already under general anesthesia for standard clinical care, Thomas Kolon, M.D., a urologist at Children's Hospital, removes a small piece, about half the size of the tip of a pencil eraser, from one of the testes. Half of each specimen is frozen for potential future use. The remaining half is saved for research and analysis in Dr. Brinster's lab. In all cases, the biopsy was done safely, without any negative side effects such as excessive bleeding, pain or infection.

All of the families in the study completed a questionnaire regarding their beliefs about fertility and the factors involved in their decision whether to freeze testicular tissue. Five of the 21 families refused the biopsy, with a key factor being that they were too overwhelmed by their child's cancer diagnosis to make the decision about the testicular biopsy. In addition, a majority of the families presented with the option said having a limited time to decide about the biopsy was stressful, as they often had to decide quickly, before therapy started. Other factors, such as religion, ethics, financial considerations, and the fact that cryopreservation is currently experimenta
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SOURCE The Children's Hospital of Philadelphia
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