Via the surgical removal of testicular tissue (see testicular biopsy), sperm can be retrieved before they are fully mature, i.e. before they arrive in the epididymis.
A testicular biopsy can be performed for diagnostic purposes. However, usually it is performed to collect and store sperm or sperm producing cells (see anatomical explanation).
Freezing testicular tissue can offer a solution for four groups of men and boys.
In principle adult men can have their sperm frozen and therefore do not have to freeze and store testicular tissue. For a number of men this is the case though:
- men with azoospermia (absence of sperm in the ejaculate), who have a TESE procedure to collect testicular sperm for fertility treatment with ICSI.
If more sperm than required are retrieved, the excess sperm can be frozen for possible later use;
- men who have a vasectomy reversal, known as reanastomosis or the repair of the vas deferentia after a sterilisation. Because reanastomosis is not always successful, patients may choose to freeze testicular tissue prior to the reversal operation;
- men who will have cancer treatment that will result in sterilisation who have no sperm in their sperm sample. See www.oncofertility.be/men .
- The cancer itself can lead to a reduction in sperm production, resulting in azoospermia. Sperm can sometimes be found via TESE in the testicular tissue and be stored before the start of the cancer treatment.
- Testicles sometimes have to be removed for testicular cancer and semen can be taken from the removed testicles for freezing.
Pre-pubescent boys who have to undergo cancer treatment before puberty form a separate group. They don't yet produce sperm (see sperm production). If they have potentially sterilising cancer treatment or a blood disorder (e.g. sickle cell anaemia), their future fertility can be preserved via the collection and storage of sperm stem cells from the testicles. Stem cells are the cells from which sperm will later be produced. A testicle or testicular tissue is removed, frozen and stored, with a view to a possible future transplant.
Freezing stem cells from the testicle of pre-pubescent boys is currently still in an experimental phase. It offers no certainty of later fertility. The procedure is only performed under certain circumstances and is decided together with the child's parents, the paediatrician, the cancer specialists, and the fertility clinic.
Please go to www.brusselsoncofertility.be/boys
for more detailed information about this subject. Click on testicular stem cells for more information regarding the current research project at the CRG