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Option for FertilityPreservation in Men

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• In men, cryopreservation of ejaculate or testicular tissueare established means of creating a fertility reserve.

• A therapeutically e ective method that protectstesticular function from gonadoto ic e ects ofchemotherapy or radiotherapy has to be developed.

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In radiotherapy, shielding of the testes from radiationor removal from the radiation !eld o ers an e ectivemeasure to prevent un"anted damage and is "idelypracticed.

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#ryopreservation of $perm•

Multiple sperm donations can be provided and a fro%endepot created and maintained in reproductive medicalcenters, prior to the start of gonadoto ic treatment.

• $permato%oa are relatively cryoresistant and post&tha"survival rate is high.

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For prepubertal boys, cryopreservation of sperm isinappropriate because provision of an ejaculate is notyet possible.

• For adolescent boys undergoing puberty, germ cells canbe obtained for cryo& preservation through e tractionfrom testicular biopsies or by electroejaculation

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#ryopreservation of $perm from 'esticular 'issue (')$)*

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A testicular biopsy could be performed to isolatespermato%oa from testicular tissue "hen nospermato%oa are found in the ejaculate.

• ')$) is an established process and is combined "ithintracytoplasmic sperm injection (I#$I* for later fertility.

• 'he socalled Onco&')$) is particularly useful in patients"ith unilateral or bilateral testicular tumors, as "ell aspatients "ith a%oospermia before or after gonadoto ictherapy

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) perimental Approaches•

+ecovery of testicular tissue via biopsy provides amethod for recovery of germ line stem cells before thestart of treatment "hich can be maintained throughcryopreservation.

• 'his is currently the only conceivable method to

preserve fertility for prepubertal boys and, therefore,the cryopreservation of immature testicular tissueshould be considered for these patients