机构地区:[1]Department of Gynaecology,Fertility,and Obstetrics,Laboratory of Reproductive Biology,University Hospital of Copenhagen,Rigshospitalet,Copenhagen 2100,Denmark [2]Department of Pediatric Surgery,University Hospital of Copenhagen,Rigshospitalet,Copenhagen 2100,Denmark [3]Department of Clinical Medicine,University of Copenhagen,Copenhagen 2100,Denmark [4]Department of Pediatrics and Adolescent Medicine,Copenhagen University Hospital Hvidovre,Hvidovre 2650,Denmark [5]Centre of Andrology and Fertility Clinic,Department D,Odense University Hospital,Odense 5000,Denmark [6]Research Unit of Human Reproduction,Department of Clinical Research,University of Southern Denmark,Odense 5000,Denmark [7]Fertility Clinic,University Hospital of Copenhagen,Herlev and Gentofte Hospital,Herlev 2730,Denmark
出 处:《Asian Journal of Andrology》2024年第6期610-616,共7页亚洲男性学杂志(英文版)
基 金:financially supported by the University Hospital of Copenhagen,Rigshospitalet,the Danish Child Cancer Foundation(2021-7395);Vissing Fonden(519140 AHO/PPT);the Research Fund between Rigshospitalet and Odense University Hospital(136-A5544).
摘 要:This study assessed the feasibility of testis tissue cryopreservation (TTC) for fertility preservation in prepubescent boys with cryptorchidism. From January 2014 to December 2022, the University Hospital of Copenhagen (Rigshospitalet, Copenhagen, Denmark) implemented TTC for 56 boys with cryptorchidism to preserve their reproductive potential. Testis tissue samples were collected during orchiopexy (32 cases) or at subsequent follow-up procedures (24 cases), necessitated by an increased risk of infertility as indicated by hormonal assessments and/or findings from initial surgical biopsies. Testis samples were procured for TTC and pathological analysis. The cohort had an average age of 1.3 (range: 0.3–3.8) years at the time of orchiopexy, with 91.1% presenting bilateral cryptorchidism. The study revealed a median germ cell count of 0.39 (range: 0–2.88) per seminiferous tubule, with germ cells detected in 98.0% of the bilateral biopsies and 100% of the unilateral, indicating a substantial potential for fertility in these immature tissues. A dark spermatogonia (Ad) was detected in 37 out of 56 patients evaluated, with a median Ad spermatogonia count of 0.027 (range: 0.002–0.158) per seminiferous tubule. A total of 30.2% of the samples lacked Ad spermatogonia, indicative of potential gonadotrophin insufficiency. The median hormone levels measured were as follows: follicle-stimulating hormone (FSH) at 0.69 (range: 0.16–2.5) U l−1, luteinizing hormone (LH) at 0.21 (range: 0.05–3.86) U l−1, and inhibin B at 126 (range: 17–300) pg ml−1. Despite early orchiopexy, 20%–25% of boys with cryptorchidism remain at risk for future infertility, substantiating the necessity of TTC as a precaution. The study highlights the need for refined predictive techniques to identify boys at higher risk of future infertility.
关 键 词:cryopreservation of testis tissue CRYPTORCHIDISM fertility preservation germ cells male infertility prepubescent spermatogonial stem cells TESTIS
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