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In men cured of childhood cancer, fertility disorders related to damage to the stock of spermatogonial stem cells (SSCs) constitute one of the main side effects of treatments, adversely affecting the patients' quality of life. The development of new technologies in human reproduction is necessary to provide curative solutions for this iatrogenic infertility. The preservation of immature testicular tissue (ITT) fragments is recommended for prepubescent patients expected to be exposed to highly gonadotoxic treatments. The SSCs present in the prepubertal testicle constitute a source of cells for developing future therapies with the hope of restoring fertility. Testicular stem cell transplantation and autografting of ITT fragments are potential fertility restoration techniques that have proven effective in preclinical models of non-human primates. We will discuss here the advantages and limitations of these two therapeutic approaches, which are promising for clinical application in the near future. [ABSTRACT FROM AUTHOR]

The initiation of spermatogenesis in young males reaching puberty allows for the preservation of sperm from around the age of 12. However, for prepubescent boys not yet producing sperm, the freezing of testicular tissue (CTT) is now an accepted and recommended option according to the latest guidelines from the National Cancer Institute. CTT aims to preserve spermatogonial stem cells (SSC) before administering treatments that pose a high risk of future fertility impairment. The quality of the preserved testicular tissue, based on various clinical parameters of the patient and its potential to restore fertility post-treatment, is still under discussion, highlighting the need for a personalized approach in managing the fertility of young patients. [ABSTRACT FROM AUTHOR]

Techniques for fertility preservation can be offered in women of reproductive age receiving chemotherapy. The use of a GnRH agonist during chemotherapy is one of the first techniques that has been proposed. Underlying mechanisms remain controversial, but the results of nonrandomized trials in breast cancer and other diseases were encouraging. Randomized trials in breast cancer show conflicting results, and are difficult to interpret. There are also some concerns about a possible interaction with the effectiveness of cancer treatment that remain to be evaluated, even if the data available seem to be reassuring. Thus, currently, the use of this method of fertility preservation is controversial, but should probably be mentioned and explained to patients, and eventually proposed, rather in trials. Other methods for fertility preservation currently available, that have a promising efficiency and are compatible with the use of agonists, should be preferred in these patients. [ABSTRACT FROM AUTHOR]

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