01 August 2018

Scientists are investigating methods to preserve male fertility in the face of chemotherapy or treatment with alkylating agents for treating sickle cell disease.

Gonadotoxic drugs can completely destroy the germ cells, called spermatogonia, that go on to develop into sperm, found Dr Jan-Bernd Stukenborg, of the Karolinska Institutet in Stockholm, Sweden, and colleagues.

Their work involved analysing testicular tissue taken for fertility preservation between 2014 and 2017 from 32 boys with an average age of six, living in Sweden, Finland and Iceland. The children were about to begin, or had just begun, treatments that carried a high risk of infertility: testicular irradiation, chemotherapy or radiotherapy.

Numbers of spermatogonia were compared with those in 14 healthy testicular tissue samples, saved in a biobank.

Dr Stukenborg explains: "We could compare the number of spermatogonia with those found in the healthy boys as a way to estimate the effect of medical treatment or the disease itself on the future fertility of a patient.

"We found that the numbers of germ cells present in the cross-sections of the seminiferous tubules were significantly depleted and close to zero in patients treated with alkylating agents. This was not seen in patients who had not started treatment, or were treated with non-alkylating agents, or in the biobank tissues."

The research was published in Human Reproduction.

Co-author, Dr Cecilia Petersen of the Karolinska Institutet, said: "Our findings suggest that storing frozen testicular tissue from these boys should be performed before these treatments are initiated.

"However, until sperm that are able to fertilise eggs are produced from stored testicular tissue, we cannot confirm that germ cell quantity might determine the success of transplantation of the tissue in adulthood. Further research on this is needed to establish a realistic fertility preservation technique."

Source: Stukenborg, J.B., Alves-Lopes, J.P., Kurek, M., Albalushi, H., Reda, A., Keros, V., Töhönen, V., Bjarnason, R., Romerius, P., Sundin, M. and Norén Nyström, U., Spermatogonial quantity in human prepubertal testicular tissue collected for fertility preservation prior to potentially sterilizing therapy. Human Reproduction.

Link: https://doi.org/10.1093/humrep/dey240


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