Experience and andrological follow-up after testicular tissue cryopreservation

Abstract

Research question

What is the experience and mid- and long-term andrological health follow-up of (pre)pubertal males who have undergone testicular tissue freezing (TTF)?

Design

This single-centre longitudinal retrospective cohort study reports on the mid- and long-term andrological health follow-up of (pre)pubertal males and young adults who underwent TTF for fertility preservation between January 2007 and December 2018. Medical characteristics and questionnaire data collected more than 18 months after TTF were analysed.

Results

Thirty-six patients were revisited during a medical follow-up consultation. During follow-up after TTF, 72.7% of patients could not recollect their counselling consultation prior to TTF but 42.4% of them found information about the TTF process useful and sufficient. Parents’ or legal guardians’ feedback was more positive about the counselling consultation and the TTF process. After TTF and treatment, the majority of patients (76.9%) who provided a semen sample had non-obstructive azoospermia. Higher serum concentrations of FSH and LH and lower serum concentrations of inhibin B were associated with non-obstructive azoospermia compared with patients with oligozoospermia (P = 0.0182, P = 0.0245 and P = 0.0140 respectively). During cancer treatment, about half of pubertal patients reported sexual dysfunction, decreasing to approximately 20% after treatment. However, two patients had children using sperm donation and one patient had a child through natural pregnancy.

Conclusions

The involvement of parents or legal guardians is crucial in the decision-making process for fertility preservation in (pre)pubertal boys. Regular follow-up, including the use of questionnaires, is essential to provide guidance for fertility preservation programmes and information on fertility restoration options and to address the psychosocial aspects of fertility preservation.