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2016 ; 22
(6
): 744-761
Nephropedia Template TP
gab.com Text
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English Wikipedia
Cryopreservation of testicular tissue or testicular cell suspensions: a pivotal
step in fertility preservation
#MMPMID27566839
Onofre J
; Baert Y
; Faes K
; Goossens E
Hum Reprod Update
2016[Nov]; 22
(6
): 744-761
PMID27566839
show ga
BACKGROUND: Germ cell depletion caused by chemical or physical toxicity, disease
or genetic predisposition can occur at any age. Although semen cryopreservation
is the first reflex for preserving male fertility, this cannot help out
prepubertal boys. Yet, these boys do have spermatogonial stem cells (SSCs) that
able to produce sperm at the start of puberty, which allows them to safeguard
their fertility through testicular tissue (TT) cryopreservation. SSC
transplantation (SSCT), TT grafting and recent advances in in vitro
spermatogenesis have opened new possibilities to restore fertility in humans.
However, these techniques are still at a research stage and their efficiency
depends on the amount of SSCs available for fertility restoration. Therefore,
maintaining the number of SSCs is a critical step in human fertility
preservation. Standardizing a successful cryopreservation method for TT and
testicular cell suspensions (TCSs) is most important before any clinical
application of fertility restoration could be successful. OBJECTIVE AND
RATIONALE: This review gives an overview of existing cryopreservation protocols
used in different animal models and humans. Cell recovery, cell viability, tissue
integrity and functional assays are taken into account. Additionally, biosafety
and current perspectives in male fertility preservation are discussed. SEARCH
METHODS: An extensive PubMED and MEDline database search was conducted. Relevant
studies linked to the topic were identified by the search terms:
cryopreservation, male fertility preservation, (immature)testicular tissue,
testicular cell suspension, spermatogonial stem cell, gonadotoxicity,
radiotherapy and chemotherapy. OUTCOMES: The feasibility of fertility restoration
techniques using frozen-thawed TT and TCS has been proven in animal models.
Efficient protocols for cryopreserving human TT exist and are currently applied
in the clinic. For TCSs, the highest post-thaw viability reported after
vitrification is 55.6 ± 23.8%. Yet, functional proof of fertility restoration in
the human is lacking. In addition, few to no data are available on the safety
aspects inherent to offspring generation with gametes derived from frozen-thawed
TT or TCSs. Moreover, clarification is needed on whether it is better to
cryopreserve TT or TCS. WIDER IMPLICATIONS: Fertility restoration techniques are
very promising and expected to be implemented in the clinic in the near future.
However, inter-center variability needs to be overcome and the gametes produced
for reproduction purposes need to be subjected to safety studies. With the
perspective of a future clinical application, there is a dire need to optimize
and standardize cryopreservation and safety testing before using frozen-thawed TT
of TCSs for fertility restoration.