A testicular tissue transplant surgery to preserve fertility has been conducted on a 19-year-old man by NHS Lothian in Edinburgh, following his childhood cancer treatment. This surgery is the first of its kind in the UK and only the second reported worldwide. Semen freezing for adolescent and adult males before sterilising cancer treatment has been available for over fifty years, but there is no method of preserving fertility for childhood cancer victims as they do not produce sperm.
The pioneering procedure involved the sampling of testicular tissue, and then subsequently the cryopreservation, or freezing, and eventual transplant of the sample back into the patient following cancer treatment. For the now 19-year-old patient, this took place in 2023 before his bone marrow transplant for a blood disorder.
For his and many other patients’ cancers, the required high dose chemotherapy is gonadotoxic, meaning the cells required to produce sperm are permanently damaged by the drug. In 2026, three years after the treatment, tests confirmed the absence of sperm in his semen. The testicular tissue from before the cancer treatment was then transplanted back into his body in August 2026. The patient will now be monitored closely and in April 2027 the testicular tissue will be resampled to see if it has been producing sperm. If the treatment works, which it has been proven to do to in mice and monkeys, it will mean recipients will be able to consider having children.
Survival rates for childhood cancer in developed nations are now at 80-85 per cent, and there has been a shift in research focus to the quality-of-life outcomes for these patients. As Rob Mitchell, Professor of Developmental Endocrinology at Edinburgh’s Institute for Regeneration and Repair, and a consultant paediatric endocrinologist, has outlined: the option to re-explore fertility options following cancer recovery would be “a big step towards helping boys facing treatments that damage their fertility to have children of their own.”
Through funding from Children with Cancer UK the Edinburgh testicular project has now grown into a national programme and more than 1,200 patients in the UK have had testicular tissue cryopreserved, hoping to have a successful transplant in the future.
To be confronted with the status of your fertility is something no child should have to go through whilst battling cancer. Through this Edinburgh based treatment, there is a newfound hope for male childhood cancer patients and their fertility.
Photo by Akram Huseyn on Unsplash
