Application of unilateral partial orchiectomy for fertility preservation in prepubertal boys

doi:10.3877/cma.j.issn.1674-3253.2025.06.012

Abstract

Abstract:

Objective

To explore methods for fertility preservation in prepubertal boys with severe β-thalassemia (β-TM), Ewing's sarcoma, and neuroblastoma.

Methods

To preserve fertility, 48 cases of boys (46 with severe β-TM, 1 with Ewing sarcoma, and 1 with neuroblastoma) who underwent right partial orchiectomy (removing 20-30% of the volume) in the pediatric surgery department of the Sixth Affiliated Hospital of Sun Yat-sen University from October 2023 to April 2024. The excised testicular tissue was preserved using slow programmable cryopreservation. Two parallel experiments of testicular tissue freezing in prepubertal crab-eating macaques were conducted to verify the changes in the number of spermatogonia stem cells in resuscitated frozen testicular tissue and fresh testicular tissue.

Results

The average age of 48 patients was (9.63±3.00) years, and BMI was 15.29 (14.37, 16.41) kg/m². All 48 patients successfully completed the surgery with a hospital stay of 2 (2, 3) days, intraoperative blood loss 2 (2, 5) ml,and operation time 70.0 (50.0, 99.5) min. Among them, 3 children had cryptorchidism and underwent orchiopexy during the surgery. One child developed postoperative scrotal hematoma, which improved after antibiotic treatment. Slow programmable cryopreservation was successfully used to preserve testicular tissue for all 48 boys, and the freezing process was uneventful. Compared with fresh testicular tissue, there was no significant change in the number of spermatogonia stem cells in the resuscitated frozen testicular tissue of two prepubertal crab-eating macaques.

Conclusion

For prepubertal boys with severe β-TM, Ewing sarcoma, and neuroblastoma who are candidates for hematopoietic stem cell transplantation (HSCT), partial orchiectomy is performed on one side and the testicular tissue of the child is preserved, leaving hope for them to have offspring in adulthood.

Key words: β-thalassemia, Ewing sarcoma, Neuroblastoma, Testicular tissue cryopreservation, Slow programmable freezing, Male, Spermatogonia stem cells, Fertility preservation

Juntao Li, Guihua Liu, Ziqin He, Menghui Ma, Yangjie Zhao, Chutian Xiao, Yifei Zhang, Lubin Yan, Xiaoyan Liang, Dejuan Wang. Application of unilateral partial orchiectomy for fertility preservation in prepubertal boys[J]. Chinese Journal of Endourology(Electronic Edition), 2025, 19(06): 759-764.

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