Fertility preservation/restoration approaches for male cancer patients.
| Approach | Patients | Procedure | Current observations | Advantages | Considerations | Ref |
|---|---|---|---|---|---|---|
| Sperm cryopreservation | Post-pubertal males | Collection and freezing of ejaculated semen | Standard practice | Highly effective | Not suitable for pre-pubertal boys | [114] |
| TESE | Post-pubertal males | Surgical extraction of sperm cells from testicular tissue | Standard practice | Useful for azoospermic patients | Processing TESE specimens is highly labour-intensive | [115] |
| Testicular tissue cryopreservation | Pre-pubertal or Adults | Preservation of SSCs inside the tissue | Experimental | For prepubertal boys who have not yet initiated spermache | No live births have been reported | [116] |
| Electroejaculation | Early or pubertal boys | Uses electrical stimulation via a rectal probe to induce ejaculation | Available | Effective for young boys unable to ejaculate voluntarily | Requires anaesthesia | [117] |
| Penile vibratory stimulation | Early or pubertal boys | External vibratory stimulation to produce ejaculation | Available | simple in use, non-invasive, does not require anaesthesia | Adjunct methods if ejaculate is incomplete | [118] |
| Induced pluripotent stem cells | Adults | Reprogramming adult body cells into pluripotent stem cells | Experimental | can become any cell type, including germ cells | Not yet applicable in humans | [119] |
| Testicular Sperm Aspiration | Adults | To harvest sperm a needle is inserted into the testicle to aspirate testicular tissue | Clinical practice | Cost effective | May retrieve immature sperm | [120] |
| Micro TESE | Adults | Uses a microscopy to precisely extract testicular tissues exhibiting highest likelihood of spermatogenesis | Clinical practice | Higher success rates in difficult cases | More expensive | [121] |
| Hormonal protection strategies | Post-pubertal and adults | Administration of GnRHa, temporarily suppress gonadotropin secretion to reduce testicular activity | Preclinical level | Suitable for hormone sensitive cancers | Apart from rat studies, showing conflicting outcomes; still under investigation | [122] |
VAS: Conceptualization, Methodology, Writing—original draft. PC: Conceptualization, Formal analysis, Writing—original draft. BSB: Data extraction, Writing—review & editing. BS: Visualization, Writing—review & editing. MMCM: Investigation, Resources. SA: Visualization, Validation. JRD: Project administration, Formal analysis. HC: Project administration, Investigation. All authors read and approved the final manuscript.
The authors declare that they have no conflicts of interest.
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