Fathering a child after childhood cancer treatments

Abstract

Among many deleterious ramifications of oncological treatments, there is permanent male infertility due to the damage to spermatogonial stem cells (SSC) in the testes after chemotherapy or irradiation. For those patients that cannot produce sperm before cancer treatment, because of prepubertal age, there are no clinical options available to father a child. To preserve fertility in childhood cancer patients, freezing of a testis biopsy is already offered before cancer treatment, while fertility treatment options using this biopsy are still under development, including spermatogonial stem cell transplantation (SSCT). SSCT requires isolation and in vitro propagation of spermatogonial stem cells from the cryopreserved biopsy, followed by autologous transplantation back to the adult cancer survivor. Given the implications of this potential stem cell therapy to recipients, their partners, and future offspring, we here aim to thoroughly appraise the state-of-the-art of SSCT focussing on safety for both patient and his future children.

Sperm DNA methylation is predominantly stable in mice offspring born after transplantation of long-term cultured spermatogonial stem cells

“…However, since human SSCs do show epigenetic differences after culture [29,30], epigenetic studies are needed during the follow-up of the children in Phase I clinical trials of SSCT. Before clinical implementation of SSCT as treatment in human, some safety features of the procedure still must be investigated [31,32]. The optimal cryopreservation protocol of testicular tissue has been established but has not been standardized yet [32].…”