Rapport final
Follow-up of pubertal development and fertility in boys who underwent testicular tissue biopsy for fertility preservation - Braye Aude
Patients receiving gonadotoxic treatment for cancer or hematological disorders and Klinefelter patients (genetic condition) are at high risk of losing their spermatogonial stem cells (SSCs). SSCs are present in the testes since birth and give rise to spermatozoa during puberty and throughout adulthood. SSC loss consequently results in infertility. To prevent this, cryopreservation of testicular tissue before SSC loss is an experimental strategy for fertility preservation. In 2002, the UZ Brussel initiated such a fertility preservation program for boys at high risk for SSC loss. After fertility preservation and during the gonadotoxic treatment, these boys are followed at the UZ Brussel to monitor their development. A first study identified lacks and shortcomings in this follow-up and demonstrated that the follow-up was not standardized with irregular consultations and missing data. This study also investigated the long-term impact of a testicular biopsy. The biopsy procedure has no impact on the pubertal development of Klinefelter patients. However, differences in reproductive hormone levels were observed in cancer patients after the biopsy procedure. It is unclear whether these differences result from the gonadotoxic treatment or from the biopsy procedure itself. To clarify this, a new study was started to obtain a more representative picture of the long-term impact of gonadotoxic treatments as well as the biopsy procedure. Using a standardized follow-up protocol, we are currently evaluating the pubertal development and fertility of cancer patients after fertility preservation and gonadotoxic treatment. Preliminary data suggest that the gonadotoxic treatment rather than the biopsy procedure disturbs the gonadal function in cancer patients. However, additional data are necessary to confirm this.