An experimental protocol for fertility preservation in prepubertal boys recently diagnosed with cancer: a report of acceptability and safety
An experimental protocol for fertility preservation in prepubertal boys recently diagnosed with cancer: a report of acceptability and safety
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DOI：
10.1093/humrep/dep371
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发表时间：
2010-01-01
影响因子：
6.1
通讯作者：
Kolon, T. F.
中科院分区：
文献类型：
--
作者：
Ginsberg, J. P.;Carlson, C. A.;Kolon, T. F.
性腺损伤是儿童恶性肿瘤治疗的结果。青春期前的雄性没有精液或成熟的精子，这对生育能力的保存构成了挑战。睾丸组织冷冻保存是一种潜在的选择，但仍处于实验阶段。我们报告了一项试点方案，该方案为新诊断为恶性肿瘤的青春期前男孩的家庭提供睾丸活检冷冻保存。目的是为了确定这一过程的可接受性和安全性。青春期前男孩的父母被提供了睾丸冷冻保存的选项，这些男孩被诊断为与治疗相关的性腺损伤的风险最高。一半的活组织检查被冻结，以供受试者未来潜在的使用，其余的用于研究。评估了术中和/或术后7天睾丸活检的阴性后遗症的数据。两到四周后，父母被要求完成一份关于影响他们决定是否接受活检的因素的问卷。自2008年1月以来，已有24名男孩符合资格标准，但有3名男孩需要立即接受治疗，因此被排除在外。在21个家庭中，16个家庭(76%)同意睾丸活检，这表明这一选择对3个月至14岁男孩的父母来说是可接受的；14个家庭接受了手术，手术中或手术后没有任何负面后遗症。尽管确诊时的压力很大，但家庭可以深思熟虑地考虑这个选择。宗教、经济、伦理和冷冻保存的实验性质等因素在决策中没有起到主要作用。青春期前男孩癌症患者的父母在确诊时愿意进行睾丸组织冷冻保存，睾丸活检没有造成急性不良反应。
Gonadal damage is a consequence of therapy for pediatric malignancies. Prepubertal males have no semen or mature spermatozoa, posing a challenge for fertility preservation. Testicular tissue cryopreservation is a potential option but is still experimental. We report on a pilot protocol that offered testicular biopsy cryopreservation to families of prepubertal boys with newly diagnosed malignancy. The aims were to determine the acceptability and safety of this procedure.Parents of prepubertal boys with diagnoses at highest risk for treatment-related gonadal damage were offered the option of testicular cryopreservation. Half of the biopsy was frozen for the subject's potential future use and the remainder used for research. Data on negative intraoperative and/or 7 day post-operative sequelae of testicular biopsies were assessed. Two to four weeks later, parents were asked to complete a questionnaire on factors influencing their decision to have the biopsy or not.Since January 2008, 24 boys have met the eligibility criteria but three required immediate treatment and were excluded. Sixteen of 21 families (76%) consented to testicular biopsy, indicating the prospective acceptability of this option to parents of boys aged 3 months to 14 years; 14 underwent the procedure without any negative intra- or post-operative sequelae. Although the time at diagnosis is stressful, families can give thoughtful consideration to this option. Factors such as religion, finance, ethics and the experimental nature of cryopreservation did not play a major role in decision-making.Parents of prepubertal boys with cancer are willing to pursue testicular tissue cryopreservation at diagnosis, and testicular biopsy caused no acute adverse effects.