Testicular tissue cryopreservation for fertility preservation in prepubertal and adolescent boys: A 6 year experience from a Swiss multi-center network

Dehlia Moussaoui¹, Anna Surbone², Cécile Adam³, Tamara Diesch-Furlanetto⁴, Céline Girardin⁵, Julie Bénard⁶, Isabelle Vidal⁷, Fanette Bernard^{8

9}, Kanete Busiah¹⁰, Thérèse Bouthors¹⁰, Marie-Pierre Primi¹¹, Marc Ansari^{8

9}, Nicolas Vulliemoz², Fabienne Gumy-Pause^{8

9}

Affiliations

¹ Division of General Pediatrics, Department of Woman, Child and Adolescent Medicine, Geneva University Hospitals, Geneva, Switzerland.
² Fertility Medicine and Gynaecologic Endocrinology Unit, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
³ Oncology and Hematology Unit, Service of Pediatrics, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
⁴ Division of Pediatric Oncology-Hematology, University Children's Hospital of Basel, Basel, Switzerland.
⁵ Pediatric Endocrine and Diabetes Unit, Department of Woman, Child and Adolescent Medicine, Geneva University Hospitals, Geneva, Switzerland.
⁶ Unit for Reproductive Medicine and Gynecological Endocrinology, Department of Woman, Child and Adolescent Medicine, Geneva University Hospitals, Geneva, Switzerland.
⁷ Division of Pediatric Surgery, Department of Woman, Child and Adolescent Medicine, University Center of Pediatric Surgery of Western Switzerland, Geneva University Hospitals, Geneva, Switzerland.
⁸ Pediatric Oncology and Hematology Unit, Department of Women Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland.
⁹ CANSEARCH Research Platform for Pediatric Oncology and Hematology, Department of Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
¹⁰ Pediatric Endocrinology, Diabetology and Obesity Unit, Service of Pediatrics, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
¹¹ Laboratory of Andrology and Reproductive Biology, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.

PMID: 36147816
PMCID: PMC9485727
DOI: 10.3389/fped.2022.909000

Testicular tissue cryopreservation for fertility preservation in prepubertal and adolescent boys: A 6 year experience from a Swiss multi-center network

Dehlia Moussaoui et al. Front Pediatr. 2022.

. 2022 Sep 6:10:909000.

doi: 10.3389/fped.2022.909000. eCollection 2022.

Authors

Affiliations

¹ Division of General Pediatrics, Department of Woman, Child and Adolescent Medicine, Geneva University Hospitals, Geneva, Switzerland.
² Fertility Medicine and Gynaecologic Endocrinology Unit, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
³ Oncology and Hematology Unit, Service of Pediatrics, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
⁴ Division of Pediatric Oncology-Hematology, University Children's Hospital of Basel, Basel, Switzerland.
⁵ Pediatric Endocrine and Diabetes Unit, Department of Woman, Child and Adolescent Medicine, Geneva University Hospitals, Geneva, Switzerland.
⁶ Unit for Reproductive Medicine and Gynecological Endocrinology, Department of Woman, Child and Adolescent Medicine, Geneva University Hospitals, Geneva, Switzerland.
⁷ Division of Pediatric Surgery, Department of Woman, Child and Adolescent Medicine, University Center of Pediatric Surgery of Western Switzerland, Geneva University Hospitals, Geneva, Switzerland.
⁸ Pediatric Oncology and Hematology Unit, Department of Women Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland.
⁹ CANSEARCH Research Platform for Pediatric Oncology and Hematology, Department of Pediatrics, Gynecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
¹⁰ Pediatric Endocrinology, Diabetology and Obesity Unit, Service of Pediatrics, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
¹¹ Laboratory of Andrology and Reproductive Biology, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.

PMID: 36147816
PMCID: PMC9485727
DOI: 10.3389/fped.2022.909000

Erratum in

Erratum: Testicular tissue cryopreservation for fertility preservation in prepubertal and adolescent boys: A 6 year experience from a Swiss multi-center network.
Frontiers Production Office. Frontiers Production Office. Front Pediatr. 2023 Mar 20;11:1177389. doi: 10.3389/fped.2023.1177389. eCollection 2023. Front Pediatr. 2023. PMID: 37020653 Free PMC article.

Abstract

Testicular tissue cryopreservation is the only option of fertility preservation in prepubertal boys. While it is considered experimental, since procedures to obtain mature spermatozoa from prepubertal testicular tissue are still under development, testicular tissue cryopreservation programs have emerged worldwide. Our aim was to study the feasibility and safety of a program of testicular tissue cryopreservation in prepubertal and adolescent boys facing gonadotoxic treatment in three University hospitals in Switzerland. Testicular tissue cryopreservation was accepted by 90% of families, with a total of 35 patients included. The average patient age was 8.5 years (range 7 months to 18.5 years). Malignancies were the most common diagnosis (31 patients, 88.6%) with 16 (45.7%) solid tumors and 15 (42.9%) hematological malignancies. Four (11.4%) patients had a benign condition. The main indication for testicular tissue cryopreservation was conditioning for hematologic stem cell transplantation (25 patients, 71.4%). Testicular tissue was cryopreserved according to the freezing protocol of Louvain Catholic University (Belgium), which includes either only immature testicular tissue freezing, or mature and immature testicular tissue freezing depending on the age of the patient and the presence or absence of haploid cells. The median number of spermatogonia per tubule cross-section was 2 (range 0-6) and spermatozoa were found in only one patient. Tumoral cells were found in one testicular biopsy of a leukemic patient. There were two minor adverse events and none of them required medical treatment or surgical revision. Five patients died during follow-up. Our data demonstrate the feasibility and safety of a program of testicular tissue cryopreservation coordinated by a multidisciplinary team of fertility preservation. Despite the experimental aspect of the procedure, the acceptation rate was high, which highlights the willingness of families and patients to participate in testicular tissue cryopreservation.

Keywords: fertility preservation; gonadotoxicity; oncology; prepubertal boys; testicular tissue cryopreservation.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

**Figure 1**
Diagnosis in the 35 patients, benign conditions in orange, hematological malignancies in blue, and solid tumors in green.

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Testicular tissue cryopreservation for fertility preservation in prepubertal and adolescent boys: A 6 year experience from a Swiss multi-center network

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Testicular tissue cryopreservation for fertility preservation in prepubertal and adolescent boys: A 6 year experience from a Swiss multi-center network

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Conflict of interest statement

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