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Processing and cryopreservation of testicular sperm
Published in David K. Gardner, Ariel Weissman, Colin M. Howles, Zeev Shoham, Textbook of Assisted Reproductive Techniques, 2017
Amin S. Herati, Mark C. Lindgren, Samuel J. Ohlander, Larry I. Lipshultz
A potential strategy for using the immature cryopreserved testicular tissue involves spermatogonial stem cells. Spermatogonial stem cells are capable of self-renewal and differentiation into mature spermatozoa for the sole purpose of transmission of the genome to the next generation. Germ cell transplantation was developed in rodent models and successfully performed by Brinster and Avarbock in 1994 (60). Microinjection of spermatogonial stem cell suspensions into the seminiferous tubules of infertile mice stimulated spermatogenesis. Cryopreservation of spermatogonial stem cells before the start of any cancer therapy followed by autologous intratesticular transplantation of these cells after cure offers potential for preserving fertility (60,61). Offering human spermatogonial stem cell auto-transplantation as an option for fertility preservation to patients becomes more tangible every day. There are institutions that recognize the realistic potential of this being a valid option for patients in the near future (61), so much so that they have begun to offer cryopreservation of testicular tissue in the hope that within the next 10 years science will have solved all of the intricacies of stem cell transfer to revolutionize the ability to preserve fertility.
A Woman in Full
Published in The American Journal of Bioethics, 2018
Monique A. Spillman, Robert M. Sade
Current uterus transplantation protocol (BSWHealth 2017) requires that the recipient of the transplant be able to provide oocytes for in vitro fertilization. There seems to be no medical reason for this mandate other than to exclude transgender transplantation. If the intent had been to ensure that the uterus recipient had a genetic relationship to a fetus, then donation of sperm from a transwoman before or during her transition from male to female would fulfill the need. According to the American Society of Reproductive Medicine, “Assisted reproduction may include the full range of fertility services and do not differ materially from those provided to non-transgender patients” (ASRM [American Society of Reproductive Medicine] 2015). For a transwoman, sperm preservation could occur through a masturbatory specimen, surgical extraction of sperm from the testes, or cryopreservation of testicular tissue (De Roo et al. 2016). Oocyte donation could be accomplished from a partner, egg bank, or a related donor, to create embryos for implantation. A potential limitation of this model is the assumption that the transwoman has reached sexual maturity and has the capacity for the production of sperm. For prepubertal children contemplating transition before going through puberty, the salvage of gametes is less certain (De Roo et al. 2016).
Fertility decision-making in cancer patients – current status and future directions
Published in Expert Review of Quality of Life in Cancer Care, 2018
Verena Ehrbar, Corinne Urech, Sibil Tschudin
Decision-making regarding FP affects both men and women. Yet to date no additional support has been offered for male cancer patients even though the few existing studies on men confirm that they face similar challenges to women in this critical situation [2,52]. That the body of literature focusing on fertility is far greater for female than for male cancer patients might be due to women in general being more concerned about their fertility, because they are aware of the limitations of their reproductive lifespan. It is a fact that FP procedures are more complex in women and less readily available for female cancer patients. Furthermore, there is some evidence that information processing is different in women and men and their needs with regard to the quantity of information and its character might also be different. In one qualitative study [11], men considered themselves well informed about their possibilities of banking sperm and rated the information provision about FP as a positive experience, whereas women declared unmet needs, reported insufficient information provision, described their experience as rather negative, and expressed regret [11]. Other studies reported a similar incongruence between men and women regarding fertility-related information provision and the corresponding experiences [22,23,52,87,88]. Although this speaks to the need for further emphasis on research with female cancer patients, studies focusing on men are also in demand, especially when considering that new techniques such as cryopreservation of testicular tissue are evolving and little is known about decisional conflict that might arise for men.
Utility of micro-TESE in the most severe cases of non-obstructive azoospermia
Published in Upsala Journal of Medical Sciences, 2020
Policies differ between clinics in the treatment of couples where MD-TESE is involved. The first and probably most common policy is to perform a diagnostic MD-TESE combined with cryopreservation of testicular tissue in the case of sperm retrieval (20). No parallel hormonal treatment and oocyte retrieval of the female partner end in less emotional and financial implications when sperm recovery is unsuccessful. However, in severe cases of NOA, only occasional spermatozoa are found after dissection of tubules. In subsequent IVF cycles, a high risk of not finding sufficient sperm after thawing has been reported (17).