Discovery Boosts Boys' Prospects for Post-Cancer Fertility
FRIDAY Nov. 20, 2009 -- New research suggests it may become possible for pre-pubescent boys stricken by cancer to prepare for the future when they may be infertile but still want to become natural fathers.
Scientists in the Netherlands found that testicular stem cells can be cultured and multiplied, potentially creating sperm. This raises the prospect that men made infertile by childhood cancer treatments could impregnate women by having the cells implanted in their testicles.
It may take some time to figure out how to make this process work. But a delay may not be a problem, said study co-author Ans van Pelt, since "it may easily take more than 10 years before a boy diagnosed with cancer today has a wish to have his own child."
Currently, there's no way for a boy who hasn't reached puberty to produce sperm and save it for a future time when he wants to become a natural father. Chemotherapy, in particular, can cause infertility in boys.
Van Pelt, a fertility researcher at the University of Amsterdam, and colleagues took stem cells from the testicles of six patients during prostate cancer surgery. They then tried to coax the cells to multiply.
The findings are published in the Nov. 18 issue of the Journal of the American Medical Association.
The researchers succeeded, and the stem cells, which form sperm, multiplied.
There are caveats. The cells came from adult men, not boys who haven't reached puberty. Researchers don't know if the cells can create sperm in humans. And it's possible that the cells could transmit cancer to the recipients, so researchers will have to figure out how to prevent that possibility.
Also, the costs are unclear. It may not be expensive to remove testicular tissue and store it, but work in the laboratory and transplantation into a patient could cost more, van Pelt said.
Still, van Pelt said, "this is a big step forward."
But would parents and boys undergoing chemotherapy even be thinking a decade or more ahead, especially while dealing with the strain of cancer itself?
"Yes, since the parents of these boys are very much concerned about the future fertility of their son," van Pelt said. "We have investigated this already, and found that over 60 percent of parents would want to store testicular tissue of their son."
Dr. Jill P. Ginsberg, director of the Cancer Survivorship Program at Children's Hospital of Philadelphia, said that parents of these children do indeed look forward. "Fertility is an important part of any survivor's quality of life, and families are able to understand this even at the time of diagnosis, which is incredibly stressful," she said.
Learn more about childhood cancer from the Nemours Foundation.
Posted: November 2009