Is the time right for transplanting immature testicular tissue or cells to restore male fertility? Expert perspectives on clinical implementation of autotransplantation of cryopreserved testicular tissue or cells for fertility restoration
Year: 2025
Type: review
Abstract: Transplantations of cryopreserved immature testicular tissue (ITT) or spermatogonial stem cells (SSCs) represent promising approaches to restore fertility in patients with testicular tissue or cell suspension cryopreserved for fertility preservation. With over 3000 testicular samples cryopreserved globally, clinically viable and standardized protocols restoring fertility using cryopreserved testicular tissue/cells are urgently needed. Decades of research demonstrate the feasibility of immature testicular tissue transplantation (ITTT) or spermatogonial stem cell transplantation (SSCT) in animal models, including non-human primates. However, significant challenges remain in translating these options to human clinical practice. Critical factors include rigorous patient selection, robust pre-transplant evaluations to mitigate risks of malignant cell reintroduction, and the optimization of transplantation timing to support spermatogenesis. Developing comprehensive follow-up protocols and international data-sharing frameworks is essential to optimize outcomes. While offering the potential for genetic parenthood and enhanced quality of life for cancer survivors, these techniques require further refinement to ensure safety, efficacy, and realistic expectations. This paper outlines the framework for advancing the clinical translation of autotransplantation of testicular tissue/cells through collaboration and innovation.
Authors: Myriam Safrai, Ellen Goossens, Rod T. Mitchell, Kyle E. Orwig, Callista L. Mulder, Ans M.M. van Pelt, Debra A. Gook, Aurélie Feraille, Emily Delgouffe, Jill P. Ginsberg, Jan-Bernd Stukenborg, Kathleen Duffin, Kirsi Jahnukainen, Claus Yding Andersen, Marianne D. van de Wetering, Michael P. Rimmer, Virginie Barraud-Lange, Nina Neuhaus, Sheila Lane, Hooman Sadri-Ardekani, Nathalie Rives, Christine Wyns
Institutions: Tel Aviv University, Sheba Medical Center, Vrije Universiteit Brussel, MRC Centre for Reproductive Health, University of Edinburgh, University of Pittsburgh, Magee-Womens Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam Reproduction Development, Royal Women's Hospital, The University of Melbourne, Cecos, Neuroendocrine, Endocrine and Germinal Differentiation Communication, Université de Rouen Normandie, Children's Hospital of Philadelphia, University of Pennsylvania, Uppsala University, Karolinska University Hospital, Karolinska Institutet, University of Helsinki, Helsinki University Hospital, University of Copenhagen, Herlev Hospital, Princess Máxima Center, Université Paris Cité, Hôpital Cochin, Assistance Publique – Hôpitaux de Paris, University of Münster, University of Oxford, Atrium Health Wake Forest Baptist, Cliniques Universitaires Saint-Luc, UCLouvain
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,560
OpenAlex ID: W4412441567