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19–22 APRIL, 2017, BARCELONA, SPAIN
08:05–08:08
S13-3 (PP)
★
CRYOPRESERVATION OF TESTICULAR TISSUE
IN PRE‑PUBERTAL AND ADOLESCENT BOYS AT RISK
FOR INFERTILITY: A LOW RISK PROCEDURE
Jessica M MING
1
, Michael E CHUA
1
, Anne Marie MALONEY
2
, Abha A GUPTA
2
and Armando J LORENZO
1
1) Hospital for Sick Children, Urology, Toronto, CANADA - 2) Hospital for Sick Children, Haematology/Oncology, Toronto,
CANADA
PURPOSE
Cryopreservation of testicular tissue (TT) has become an increasingly attractive option for fertility
preservation (FP) in pre-pubertal boys at risk for gonadotoxicity due to cancer therapy. At our institu-
tion, referred families undergo counselling regarding fertility risk and available FP strategies. Herein,
we report complications from a patients who elected to undergo TT biopsies for FP.
MATERIAL AND METHODS
We retrospectively reviewed 34 consecutive patients who underwent unilateral open TT biopsies
from January 2014 to October 2016. Patient diagnosis, age, concomitant procedures, anesthetic
type, complications, procedure times, planned therapy and platelet counts were evaluated.
RESULTS
Mean age at biopsy was 8.2 years (SD 3.5-12.9). Diagnoses included: 12 leukemia/lymphoma,
15 solid tumors, 7 non-oncology disorders (hemophagocytic lymphohistiocytosis, aplastic anemia).
Twenty two patients (64.7%) had planned stem cell transplants (SCT). Of all 34 children, 11 (32.4%)
had not yet received any chemotherapy; others had already had exposure to some form of therapy
preceding biopsy. Biopsies were performed in conjunction with other procedures (central line place-
ment, bone marrow biopsy, lumbar puncture, lymph node biopsy) in 29 cases (85.3%), and were
stand-alone procedures in the rest. Platelet counts averaged 229 x 109/L (SD 78.7-379.4). In cases
where a biopsy was performed as the sole operation (n=5), mean operative time was 22 minutes
(SD 8.7-30.7). Overall, two complications developed (5.9%) after biopsy, both in SCT patients:
ipsilateral epididymo-orchitis (resolved with antibiotics) and an ipsilateral torsed appendix testis
(managed conservatively).
CONCLUSIONS
In this series, TT biopsy for cryopreservation is a feasible and safe operation to be performed with
concomitant procedures with minimal added anesthetic time. It is associated with minimal risk and
gives patients a viable option for future fertility.