Prepubertal Testicular Tissue Biopsy for Fertility Preservation. Is it Safe? How much is Procured?

Background:
Paediatric cancer treatment may induce infertility. Fertility preservation for prepubertal boys include testicular tissue cryopreservation for future use. It was shown that sampling of up to 50% of the testis doesn’t impede future testicular growth.

Aim:
Assessment of safety and volume tissue procured.

Material and Methods:
A retrospective cohort analysis of data from prepubertal testicular cryopreservation in Oxford Cell and Tissue Biobank (October 2015 - January 2018). The biopsies were dissected into 2X2X1 mm segments and cryopreserved. Testis volume was measured using an orchidometer prior to the operation. Number and volume of samples collected were compared to a reference of 30% volume biopsy, targeted in most protocols.

Results:
Data from 59 patients aged 7 months – 12 years (mean 5.29±3.54 years). Patients were admitted for surgery without delaying primary treatment and discharged within 2 days without serious adverse events. Testis volume range from 1 to 6 ml (mean 3.05±1.49 ml) and 4 to 28 segments (mean 15.21±5.7) were collected. Despite the correlation between the testis volume and the age of the patients (R=0.81), no correlation was found between the patient’s age/testicular volume and the number of pieces cryopreserved (R=0.02 and R=0.02). Biopsy sample was smaller than expected (0.5-11%). Percent of testis procured was inversely related to the testicular volume (R=0.99).

Conclusion:
Prepubertal testis biopsy was safe. Testicular biopsies were smaller than expected. Since biopsy retrieval up to 50% doesn’t impede testicular growth, intraoperative measurement of testicular and biopsy weight/volume might help achieve an optimal tissue biopsy.