Testicular wedge biopsy for fertility preservation in children at significant risk for azoospermia after gonadotoxic therapy

Kristine S. Corkum*, Timothy B Lautz, Emilie Katherine Johnson, Molly B. Reimann, Amy Leanne Walz, Barbara A. Lockart, Robert E Brannigan, Hanna ValliPulaski, Kyle E. Orwig, Erin Rowell

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background/purpose: Testicular tissue cryopreservation (TTC) provides an experimental option for fertility preservation for male children at significant risk for azoospermia owing to high-risk gonadotoxic treatments. Methods: A single institution, retrospective review of TTC cases from 2015 to 2017. Children at significant risk for azoospermia were eligible for study inclusion. A unilateral wedge biopsy of the testis was performed for TTC. Results: TTC was performed in 23 patients. Average age was 10 years old (5 months to 18 years). Diagnoses included solid tumor (74%, n = 17), hematologic malignancy (17%, n = 4), and benign hematologic disease (13%, n = 3). Six patients had TTC at the time of disease relapse. Nine patients were referred for TTC prior to stem cell transplantation. The majority (70%, n = 16) of patients had an additional procedure at the time of TTC. One patient developed postoperative scrotal cellulitis that was treated with antibiotics. The majority of patients (96%, n = 22) had normal testicular tissue with the presence of germ cells on histopathological analysis. Median time to start of medical therapy was seven days with no unanticipated treatment delays. Conclusions: Testicular wedge biopsy for TTC can be performed safely, coordinated with other necessary procedures, and does not delay the start of treatment. TTC remains an experimental option for fertility preservation for children, as no spermatogenic recovery or pregnancies from cryopreserved testicular tissues have been reported to date. Level of evidence: IV.

Original languageEnglish (US)
JournalJournal of pediatric surgery
DOIs
StatePublished - Jan 1 2019

Fingerprint

Fertility Preservation
Azoospermia
Cryopreservation
Biopsy
Therapeutics
Cellulitis
Hematologic Diseases
Stem Cell Transplantation
Hematologic Neoplasms
Germ Cells
Testis

Keywords

  • Children
  • Fertility preservation
  • Testicular tissue cryopreservation
  • Wedge biopsy

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

@article{e88ba4760c094a5cba11bc09ca3b406e,
title = "Testicular wedge biopsy for fertility preservation in children at significant risk for azoospermia after gonadotoxic therapy",
abstract = "Background/purpose: Testicular tissue cryopreservation (TTC) provides an experimental option for fertility preservation for male children at significant risk for azoospermia owing to high-risk gonadotoxic treatments. Methods: A single institution, retrospective review of TTC cases from 2015 to 2017. Children at significant risk for azoospermia were eligible for study inclusion. A unilateral wedge biopsy of the testis was performed for TTC. Results: TTC was performed in 23 patients. Average age was 10 years old (5 months to 18 years). Diagnoses included solid tumor (74{\%}, n = 17), hematologic malignancy (17{\%}, n = 4), and benign hematologic disease (13{\%}, n = 3). Six patients had TTC at the time of disease relapse. Nine patients were referred for TTC prior to stem cell transplantation. The majority (70{\%}, n = 16) of patients had an additional procedure at the time of TTC. One patient developed postoperative scrotal cellulitis that was treated with antibiotics. The majority of patients (96{\%}, n = 22) had normal testicular tissue with the presence of germ cells on histopathological analysis. Median time to start of medical therapy was seven days with no unanticipated treatment delays. Conclusions: Testicular wedge biopsy for TTC can be performed safely, coordinated with other necessary procedures, and does not delay the start of treatment. TTC remains an experimental option for fertility preservation for children, as no spermatogenic recovery or pregnancies from cryopreserved testicular tissues have been reported to date. Level of evidence: IV.",
keywords = "Children, Fertility preservation, Testicular tissue cryopreservation, Wedge biopsy",
author = "Corkum, {Kristine S.} and Lautz, {Timothy B} and Johnson, {Emilie Katherine} and Reimann, {Molly B.} and Walz, {Amy Leanne} and Lockart, {Barbara A.} and Brannigan, {Robert E} and Hanna ValliPulaski and Orwig, {Kyle E.} and Erin Rowell",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jpedsurg.2019.01.055",
language = "English (US)",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
publisher = "W.B. Saunders Ltd",

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Testicular wedge biopsy for fertility preservation in children at significant risk for azoospermia after gonadotoxic therapy. / Corkum, Kristine S.; Lautz, Timothy B; Johnson, Emilie Katherine; Reimann, Molly B.; Walz, Amy Leanne; Lockart, Barbara A.; Brannigan, Robert E; ValliPulaski, Hanna; Orwig, Kyle E.; Rowell, Erin.

In: Journal of pediatric surgery, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Testicular wedge biopsy for fertility preservation in children at significant risk for azoospermia after gonadotoxic therapy

AU - Corkum, Kristine S.

AU - Lautz, Timothy B

AU - Johnson, Emilie Katherine

AU - Reimann, Molly B.

AU - Walz, Amy Leanne

AU - Lockart, Barbara A.

AU - Brannigan, Robert E

AU - ValliPulaski, Hanna

AU - Orwig, Kyle E.

AU - Rowell, Erin

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background/purpose: Testicular tissue cryopreservation (TTC) provides an experimental option for fertility preservation for male children at significant risk for azoospermia owing to high-risk gonadotoxic treatments. Methods: A single institution, retrospective review of TTC cases from 2015 to 2017. Children at significant risk for azoospermia were eligible for study inclusion. A unilateral wedge biopsy of the testis was performed for TTC. Results: TTC was performed in 23 patients. Average age was 10 years old (5 months to 18 years). Diagnoses included solid tumor (74%, n = 17), hematologic malignancy (17%, n = 4), and benign hematologic disease (13%, n = 3). Six patients had TTC at the time of disease relapse. Nine patients were referred for TTC prior to stem cell transplantation. The majority (70%, n = 16) of patients had an additional procedure at the time of TTC. One patient developed postoperative scrotal cellulitis that was treated with antibiotics. The majority of patients (96%, n = 22) had normal testicular tissue with the presence of germ cells on histopathological analysis. Median time to start of medical therapy was seven days with no unanticipated treatment delays. Conclusions: Testicular wedge biopsy for TTC can be performed safely, coordinated with other necessary procedures, and does not delay the start of treatment. TTC remains an experimental option for fertility preservation for children, as no spermatogenic recovery or pregnancies from cryopreserved testicular tissues have been reported to date. Level of evidence: IV.

AB - Background/purpose: Testicular tissue cryopreservation (TTC) provides an experimental option for fertility preservation for male children at significant risk for azoospermia owing to high-risk gonadotoxic treatments. Methods: A single institution, retrospective review of TTC cases from 2015 to 2017. Children at significant risk for azoospermia were eligible for study inclusion. A unilateral wedge biopsy of the testis was performed for TTC. Results: TTC was performed in 23 patients. Average age was 10 years old (5 months to 18 years). Diagnoses included solid tumor (74%, n = 17), hematologic malignancy (17%, n = 4), and benign hematologic disease (13%, n = 3). Six patients had TTC at the time of disease relapse. Nine patients were referred for TTC prior to stem cell transplantation. The majority (70%, n = 16) of patients had an additional procedure at the time of TTC. One patient developed postoperative scrotal cellulitis that was treated with antibiotics. The majority of patients (96%, n = 22) had normal testicular tissue with the presence of germ cells on histopathological analysis. Median time to start of medical therapy was seven days with no unanticipated treatment delays. Conclusions: Testicular wedge biopsy for TTC can be performed safely, coordinated with other necessary procedures, and does not delay the start of treatment. TTC remains an experimental option for fertility preservation for children, as no spermatogenic recovery or pregnancies from cryopreserved testicular tissues have been reported to date. Level of evidence: IV.

KW - Children

KW - Fertility preservation

KW - Testicular tissue cryopreservation

KW - Wedge biopsy

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