Infertile man who received world’s first frozen testicular tissue implant now has hopes of starting a family

An infertile man who received the world’s first frozen testicular tissue implant has new hope of starting a family after being able to produce sperm.

The now 27-year-old had tissue from his testicles frozen before undergoing toxic chemotherapy as a child to treat sickle cell disease.

He had the tissue transplanted again last year – 16 years after it was removed – and tests show he is now producing mature sperm.

This is the first time that a transplant of ‘cryopreserved prepubertal testicular tissue’ has been shown to restore sperm production in an adult patient.

Professor Ellen Goossens, who led the groundbreaking work at the Vrije Universiteit Brussel in Belgium, said: ‘This is a huge finding. Many more people will have the hope that they can have biological children.

“It’s great to see for the patients whose tissue we already have in storage.”

Treatments such as chemotherapy and radiotherapy can be lifesaving for childhood cancer and sickle cell patients, but can also make them infertile.

After puberty, it is possible to store sperm from male patients for later use in IVF, but for prepubertal boys this is not an option.

This is the first time that a transplant of ‘cryopreserved prepubertal testicular tissue’ has been shown to restore sperm production in an adult patient.

In 2002, the Belgian clinic was the first to start banking testicular tissue from prepubertal patients.

The immature testicles contain spermatogonial stem cells – the precursors of sperm – and Sertoli cells, essential ‘nurse cells’ that support and nourish developing sperm cells.

“At the time, this field was still in its infancy,” Professor Goossens told the Guardian.

‘These methods have only just been developed in animals. We told the patients’ families that we could not guarantee that fertility restoration would be successful.”

The first wave of patients at the clinic are now reaching their mid-20s and some have reached the point where they want to start a family, including the first man to have tissue transplanted again.

He had received high-dose chemotherapy in 2008 to eradicate his own blood cells before undergoing a bone marrow transplant.

Before treatment, the clinic surgically removed one testicle, cut it into small pieces and froze the tissue.

Last year, four tissue fragments were transplanted back into the remaining testicle and four under the skin of the scrotum.

Before treatment, the clinic surgically removed one testicle, cut it into small pieces and froze the tissue.

After a year in the body, the grafts were removed and analyzed in a laboratory.

Two of the transplants from the testicle had produced mature sperm, which was collected and frozen.

“The sperm that was isolated looked normal,” said Professor Goossens, before warning: “We still have to see if it can fertilize an egg.”

Because the implanted tissue is not directly connected to the vas deferens, the researchers do not expect sperm cells to end up in the semen naturally.

The patient is now considering whether to undergo a second round of transplantation with the aim of collecting more sperm, or whether to proceed to IVF soon.

The findings have yet to be peer-reviewed, meaning they have not been independently checked for accuracy and quality by experts in the field before being published.

Detailing their findings online, the researchers caution that pregnancy requires careful monitoring.

They wrote: ‘As the patient plans to pursue biological parenthood, close monitoring of embryo development, pregnancy progress, and long-term health outcomes in any offspring will be essential to ensure both the safety and efficacy of this approach to fertility restoration.’

Professor Rod Mitchell, a pediatric endocrinologist, is conducting a similar study at the University of Edinburgh’s Center for Reproductive Health, which began banking testicular tissue in 2014 and, along with colleagues in Oxford and London, has frozen samples from more than 1,000 British patients.

He told the Guardian that he expects his clinic to perform the first transplants soon, adding: ‘There is now proof of principle in humans that this approach is going to work, which is amazing.

‘I always believed it would work.

‘If you freeze tissue and keep cells alive, they should have that potential.

‘You place the tissue back in the perfect environment to stimulate it. Scientifically and biologically speaking, it makes sense. In reality, it’s still great.’

Testicular tissue has already been stored in more than 3,000 patients worldwide. In the UK it is estimated that around 200 patients will benefit each year.

Professor Mitchell added: ‘We’re at a point where we’ve been working on this internationally for 15 years – in some cases even longer.

“It was all about collecting tissue from the boys. Now it’s starting to pay off. We are all super excited about it.

“One of the things we want to make sure is that people are aware of this. We know we’re not necessarily reaching them all.”