Preserving Fertility For Young Cancer Patients

SciWorks Radio is a production of 88.5 WFDD and SciWorks, the Science Center and Environmental Park of Forsyth County, located in Winston-Salem.

While undergoing treatment for cancer, patients run the risk of infertility. This can be emotionally devastating. In men, the solution is fairly straight forward: collect a sperm sample before undergoing treatment and freeze, or “bank,” it. The sample can be used to impregnate a future partner. But what if the patient is a child who is not yet producing mature sperm cells? It would seem that the individual will run the risk of going through life without the ability to procreate, and indeed this has been the case. But currently, a team lead by Dr. Anthony Atala, MD, Director of the Wake Forest Institute for Regenerative Medicine, has come up with a solution.

One of the challenges that we see with children who are undergoing cancer treatment is that often they are undergoing treatments that may damage their fertility potential for the future. If that were to happen it becomes very problematic because these patients have now been saved from their cancer, which is a great thing, but at the end of the day, their fertility potential, the ability for them to have children is highly limited, or maybe even impeded. And so the goal here is to actually obtain tissue, testicular tissue, from these patients prior to them undergoing the treatment so we can then in the future isolate stem cells from this region and then allow these cells to do what they need to do for fertility purposes. What we have been able to define in the laboratory is that it is indeed possible to take testicular tissue, that is, the tissue that makes sperm in males, and then we are able to “drive” those cells to become sperm-like cells that will have the potential some day to be used clinically.

The collection technique is developed, and the process has been completed in the lab through pre-clinical investigation. However there is still work to be done.

We've been able to do this now, using human cells, up to a certain point. So we've been able to drive these cells up to a certain point where we know that they are precursors of sperm. What we'd like to do is continue that work so we get it all the way through; all the way to the finish line. But you know, right now we are dealing with children who are receiving these treatments who are eight, nine, ten years of age in some instances, and so the question is, when they are ready for their fertility cycle, which will be in another ten, fifteen, twenty years, we want to be sure that the technologies at that stage will be advanced enough that we can really use these technologies for them specifically. We currently have the technology to be able to harvest this tissue with no injury to the patient. Where we can take a very small amount of this tissue and preserve it. And we know that we can preserve this tissue, and we know we can drive this tissue along the lineage of stem cells that can give rise to sperm-like cells. And therefore we know that it is just a matter of time before we can do this in humans. So, having the ability of these patients to store this now would be helpful to them in the future. And, they are our investigational arm.

Even though the sperm production has not been perfected in humans, Dr. Atala has confidence that it will be.

We are currently, already enrolling patients in this, so currently we have children who are scheduled to start undergoing treatment that may be damaging. And so we have been able now to obtain this tissue, and to preserve it to make sure and insure that this tissue does not get injured, and that we can preserve it for future use. One of the challenges in children, of course, is that sperm is not mature, and so even if you collect sperm early on, the sperm that you collect may not be useful in the future. So, by collecting the cells that make the sperm then you're able to really capture the cells at the point where you can put them back into the same patient, and allow that patient to make their own sperm in the future.

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