Frozen tissue service offers fertility hope to young people with cancer

BMJ 2016; 354 doi: (Published 18 July 2016) Cite this as: BMJ 2016;354:i3955
  1. Jacqui Wise
  1. London

Scientists at Edinburgh University have developed a service to store testicular tissue from boys as young as 1 who are at risk of infertility because of cancer treatment. In future boys as well as girls might be able to have their fertility restored subsequent to chemotherapy.

The announcement comes after the birth of the first UK baby to be born after his mother had a transplant of her own, previously frozen, ovary tissue. The 33 year old woman from Edinburgh had a section of her ovary removed 11 years ago, having developed a rare form of cancer. Her ovarian tissue was re-implanted last year after she underwent chemotherapy. She subsequently conceived naturally and gave birth to a healthy baby boy earlier this month.

Richard Anderson, the Elsie Inglis chair of clinical reproductive science at the MRC Centre for Reproductive Health, University of Edinburgh, said, “The storage of ovarian tissue to allow restoration of fertility after cancer treatment in girls and young women was pioneered in Edinburgh over 20 years ago, and it is wonderful to see it come to fruition. This gives real hope to girls and young women facing treatment that may cause them to become infertile and shows how some medical advances can take a long time to show their benefits.”

Girls are born with a full complement of egg cells that can be frozen for transplant at a later stage. But in boys, restoring fertility has been more challenging because the testicular tissue of prepubescent boys cannot produce sperm.

Rod Mitchell, Wellcome Trust intermediate clinical fellow at the MRC centre, told The BMJ, “For postpubescent boys and adult males, freezing sperm to use later is well established. But for prepubescent boys who are going to have treatment for cancer, at the moment there is nothing that can be done, as the testicular tissue is not yet able to produce sperm.”

In the past six months the unit has been offering a service, which involved taking a biopsy of testicular tissue and cryopreserving it, to prepubertal boys who needed cancer treatment. The team is currently investigating how to turn the immature testicular tissue into sperm cells.

Mitchell said, “We don’t yet know if it is possible, but there are good animal studies showing that it is technically feasible.” He explained that he currently expects the service to be offered to one or two boys a year. “Most oncologists don’t know it is available at the moment, and we hope to increase the numbers,” he said.

The research has been funded by the Wellcome Trust, Children with Cancer, the European Union, the Medical Research Council and has involved close collaboration with the Scottish National Blood Transfusion Service.

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