From:  Beyond survival: how paediatric and adolescent chemotherapy shapes male fertility in adulthood

 Fertility preservation/restoration approaches for male cancer patients.

ApproachPatientsProcedureCurrent observationsAdvantagesConsiderationsRef
Sperm cryopreservationPost-pubertal malesCollection and freezing of ejaculated semenStandard practiceHighly effectiveNot suitable for pre-pubertal boys[114]
TESEPost-pubertal malesSurgical extraction of sperm cells from testicular tissueStandard practiceUseful for azoospermic patientsProcessing TESE specimens is highly labour-intensive[115]
Testicular tissue cryopreservationPre-pubertal or AdultsPreservation of SSCs inside the tissueExperimentalFor prepubertal boys who have not yet initiated spermacheNo live births have been reported[116]
ElectroejaculationEarly or pubertal boysUses electrical stimulation via a rectal probe to induce ejaculationAvailableEffective for young boys unable to ejaculate voluntarily Requires anaesthesia[117]
Penile vibratory stimulationEarly or pubertal boysExternal vibratory stimulation to produce ejaculationAvailablesimple in use, non-invasive, does not require anaesthesiaAdjunct methods if ejaculate is incomplete[118]
Induced pluripotent stem cellsAdultsReprogramming adult body cells into pluripotent stem cellsExperimentalcan become any cell type, including germ cellsNot yet applicable in humans[119]
Testicular Sperm AspirationAdultsTo harvest sperm a needle is inserted into the testicle to aspirate testicular tissueClinical practiceCost effectiveMay retrieve immature sperm[120]
Micro TESEAdultsUses a microscopy to precisely extract testicular tissues exhibiting highest likelihood of spermatogenesisClinical practiceHigher success rates in difficult casesMore expensive[121]
Hormonal protection strategiesPost-pubertal and adultsAdministration of GnRHa, temporarily suppress gonadotropin secretion to reduce testicular activityPreclinical levelSuitable for hormone sensitive cancersApart from rat studies, showing conflicting outcomes; still under investigation[122]