TY - JOUR

T1 - Microdissection testicular sperm extraction after pediatric allogeneic hematopoietic stem cell transplantation

T2 - a case series

AU - Mathiesen, Sidsel

AU - Jensen, Christian Fuglesang S.

AU - Byrjalsen, Anna

AU - Aksglaede, Lise

AU - Jørgensen, Niels

AU - Ohl, Dana

AU - Sønksen, Jens

AU - Müller, Klaus

N1 - Funding Information: This work was funded by unrestricted grants from The Danish Childhood Cancer Foundation and C.C. Klestrup og hustru Henriette Klestrup’s mindelegat.

PY - 2024

Y1 - 2024

N2 - Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for children with life-threatening hematological diseases, but the procedure comprises a high risk of infertility. We have previously shown that two-thirds of male survivors had azoospermia median 18 years after pediatric HSCT [1]. However, some patients with azoospermia may produce sperm that do not reach the ejaculate, giving hope for biological paternity. Microdissection testicular sperm extraction (mTESE) is a surgical procedure for men with non-obstructive azoospermia [2]. During mTESE, the testicular tissue is systematically examined using an operating microscope to identify dilated seminiferous tubules that may contain active sperm production. Biopsies from such areas are examined for the presence of mature spermatozoa that, if found, are cryopreserved for assisted reproduction. mTESE is not routinely offered to men with azoospermia after HSCT, and the literature is, to our knowledge, limited to 15 case reports worldwide [3,4,5]. Here we present a case series of five male survivors of pediatric allogeneic HSCT who, due to their wish of biological paternity, underwent mTESE for the purpose of future assisted reproduction.

AB - Allogeneic hematopoietic stem cell transplantation (HSCT) is a potentially curative treatment for children with life-threatening hematological diseases, but the procedure comprises a high risk of infertility. We have previously shown that two-thirds of male survivors had azoospermia median 18 years after pediatric HSCT [1]. However, some patients with azoospermia may produce sperm that do not reach the ejaculate, giving hope for biological paternity. Microdissection testicular sperm extraction (mTESE) is a surgical procedure for men with non-obstructive azoospermia [2]. During mTESE, the testicular tissue is systematically examined using an operating microscope to identify dilated seminiferous tubules that may contain active sperm production. Biopsies from such areas are examined for the presence of mature spermatozoa that, if found, are cryopreserved for assisted reproduction. mTESE is not routinely offered to men with azoospermia after HSCT, and the literature is, to our knowledge, limited to 15 case reports worldwide [3,4,5]. Here we present a case series of five male survivors of pediatric allogeneic HSCT who, due to their wish of biological paternity, underwent mTESE for the purpose of future assisted reproduction.

U2 - 10.1038/s41409-023-02152-8

DO - 10.1038/s41409-023-02152-8

M3 - Letter

C2 - 38007530

AN - SCOPUS:85177651824

VL - 59

SP - 274

EP - 277

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

IS - 2

ER -