Endocrine Abstracts

Cryopreservation of spermatozoa, has been utilized for decennia as an easily accessible tool in male fertility preservation, prior to treatment for cancer and autoimmune diseases. However, although this technique is well established, there is a number of questions regarding this procedure which still needs to be answered. Which patient groups should be offered semen cryopreservation? Are spermatozoa preserved prior to treatment safer to use for fertilization than fresh, ejaculated sperms produced after completion of cancer treatment including radiotherapy and/or medical treatment potentially hazardous to DNA? Should young cancer survivors with severe oligozoospermia be offered fertility preservation because they are at risk of azoospermia due to age related deterioration of spermatogenesis? Another emerging aspect is the question whether the indication for cryopreserving sperms should be widened: Increasing parental age is a global and well-known phenomenon. There is now an evidence showing that high paternal age is associated with increased risk of transmitting mutations and premature birth as well as higher infantile mortality. One could, therefore, consider offering freezing of spermatozoa to men wishing to postpone their fatherhood. Men with azoospermia as well as pre- and early pubertal boys represent a specific challenge due to lack of access to ejaculated sperms which can be used for cryobanking. Currently, several research groups are making attempts to develop techniques for in vitro and in vivo maturation and generation of germ cells suitable for assisted reproduction. Although we are still waiting for the final breakthrough in treatment of humans, the results of experimental studies give promises, that we in a near future will have access to one or more options for helping men for whom biological fatherhood, so far, is not possible. The development in the field of medical technology will provide new options for preserving male fertility. However, it will also lead to new ethical questions which need to be considered before the new methods become a clinical routine.