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Purging of malignant cell contamination prior to spermatogonia stem cell autotransplantation to preserve fertility

progress & prospects

Abdelaal, Omara,b; Barber, Heathera; Atala, Anthonya,c; Sadri-Ardekani, Hoomana,c

Current Opinion in Endocrinology, Diabetes and Obesity: June 2019 - Volume 26 - Issue 3 - p 166–174
doi: 10.1097/MED.0000000000000481
ANDROGENS: Edited by David Handelsman

Purpose of review This systematic review evaluates the state of the art in terms of strategies used to detect and remove contaminated malignant cells from testicular biopsy prior to spermatogonia stem cells (SSCs) autotransplantation to restore fertility.

Recent findings Several trials have been done in past two decades to determine the reliable methods of detecting and purging cancer cells prior to SSCs autotransplantation.

Summary The success in treating childhood cancer has dramatically increased over the past few decades. This leads to increasing demand for a method of fertility preservation for patients with pediatric cancer, as many cancer therapies can be gonadotoxic. Storing the SSCs prior to chemo- or radiation therapies and transplanting them back has been tested as a method of restoring fertility in rodents and nonhuman primate models. This has promise for restoring fertility in childhood cancer survivors. One of the major concerns is the possibility of malignant cell presence in testicular tissue biopsies that could re-introduce cancer to the patient after SSCs autotransplantation. Non-solid cancers – especially hematologic malignancies – have the risk of being transplanted back into patients after SSCs cryopreservation even if they were only present in small number in the stored testicular tissue biopsy.

aWake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA

bDepartment of Urology, Faculty of Medicine, Zagazig University, Egypt

cDepartment of Urology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA

Correspondence to Hooman Sadri-Ardekani, MD, PhD, Wake Forest Institute for Regenerative Medicine and Department of Urology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA. Tel: +1 336 713 1493; fax: +1 336 713 5754; e-mail:

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