Fertility Preservation Strategies in Pediatric Oncology
Summary
Growing survival rates in childhood cancer have led to increasing concern over long-term gonadal damage caused by chemotherapy and radiotherapy. Prepubertal patients cannot produce mature gametes, so fertility preservation strategies must focus on immature gonadal tissue rather than conventional sperm or oocyte banking. Current approaches involve cryopreservation of ovarian or testicular fragments before treatment, followed by either autotransplantation, xenografting or in vitro maturation to restore reproductive potential. Spermatogonial stem cells are isolated and expanded in culture, while organotypic systems and tissue-engineering scaffolds aim to support full gametogenesis ex vivo. International surveys highlight variability in clinical protocols, cryoprotectant use and follow-up, underscoring the need for harmonised standards. Ethical, logistical and safety considerations, including the risk of reintroducing malignant cells, continue to drive experimental refinement and multidisciplinary collaboration.
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Fertility Preservation Strategies in Pediatric Oncology publication trend
The graph below shows the total number of articles in fertility preservation strategies in pediatric oncology across all publications each year (not limited to Nature Index journals).
Technical terms
Gonadotoxic: Harmful to ovarian or testicular function, often referring to treatment-induced damage.
Cryopreservation: The process of preserving cells or tissues at ultra-low temperatures to maintain viability.
Immature testicular tissue (ITT): Prepubertal testicular fragments containing spermatogonial stem cells but not mature spermatozoa.
Spermatogonial stem cells (SSCs): Undifferentiated germ cells that give rise to sperm through spermatogenesis.
Vitrification: A rapid freezing method that prevents ice crystal formation by solidifying tissues into a glass-like state.
Xenografting: Transplantation of human tissue into an animal host to support tissue maturation or function.
References
- A 20-year overview of fertility preservation in boys: new insights gained through a comprehensive international survey. Human Reproduction Open (2024).
- Male fertility restoration: in vivo and in vitro stem cell–based strategies using cryopreserved testis tissue: a scoping review. Fertility and Sterility (2024).
- Advancements in fertility preservation strategies for pediatric male cancer patients: a review of cryopreservation and transplantation of immature testicular tissue. Reproductive Biology and Endocrinology (2024).
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