UPMC Video Rounds - Onco-Fertility Program

December 23, 2019

 

Glenn Cannon, MD, chief, Division of Pediatric Urology:

Pre-pubertal boys do present a particular challenge in preserving their fertility when they will require genetic toxic chemotherapy that would be expected to make them infertile. So therefore, we have the opportunity to harvest those spermatogonial stem cells. 

Patients are given the option of either proceeding with an open testicular biopsy or a complete simple orchiectomy to perform the spermatogonial stem cell harvest. It is possible to isolate the stem cells from children who have already undergone chemotherapy as long as they not have undergone the fully genetic toxic dose of chemotherapy. And that's important for families because many families don't learn about these fertility preservation options until after their child has received at least one dose of chemotherapy. 

Now the onco-fertility program has reached a level of maturation that we are now at the point where we are ready to begin replanting spermatogonial stem cells back into our patients who have successfully undergone chemotherapy for their original disease process. Specifically it involves a an ultrasound guided needle injection into the rete testes of which the spermatogonial stem cells are re-injected along with ultrasound guided bubbles, micro bubble contrast that ensures an adequate and complete distribution of the spermatogonial stem cells throughout the entire testes.

So the ultimate measure of success is actual paternity that these boys will grow up and father children of their own. It will take us many years to determine that. Our more immediate goal within the next five years would be to re-implant cells into adolescence who underwent the harvest when they were originally younger and hopefully restore their fertility potential so that in the more distant future when they are ready to have children of their own the best hope is that they'll be able to.

 

Learn more about the UPMC Division of Pediatric Urology.