Great expectations

Juliet Tizzard

Progress Educational Trust

05 February 2002

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[BioNews, London] This week's BioNews reports on a man who has become a father after a testicular tissue transplant to restore his fertility. This news, coupled with last week's development in ovarian tissue transplants, demonstrates just how far we've come in the treatment of cancer.

Not so many years ago, just surviving the disease was all many patients could expect to hope for. With advances in cancer care, patients can now have higher expectations. But the treatments available, whilst they are better at beating cancer, still pose a real threat to the future fertility of the patient. For younger cancer survivors, this can be a double whammy, who after getting over a terrible illness, are forced to consider a future without children.

Reproductive medicine has provided some hope in this respect. The freezing of sperm and later of embryos has enabled men and couples to literally put their reproductive potential on ice until they are ready to think about parenthood. More recently, egg freezing has offered single women the same hope, although the success rate of egg freezing remains low.

Unfortunately, none of this is relevant to those patients who are unable to produce mature gametes, either because they are too young or too sick. Testicular and ovarian tissue storage may offer an alternative here: such tissue could be collected before treatment, stored, and returned to the patient, leaving them able to reproduce as normal when they choose to. However, it is still early days for testicular and ovarian tissue storage and transplant. The few successes so far are encouraging, but should not be interpreted as a realistic option for fertility restoration. There is still a lot of research to be conducted. But maybe in the future, our expectations for preserving fertility will be as high as our expectations of surviving cancer.

Reproduced with permission from BioNews, an email and online sources of news, information and comment on assisted reproduction and genetics.