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Medical treatments for cancers or other conditions can lead to permanent infertility. Infertility is an insidious disease that impacts not only the ability to have a biological child, but also the emotional well-being of the infertile individuals, relationships, finances, and overall health. Therefore, all patients should be educated about the effects of their medical treatments on future fertility and about fertility preservation options. The standard fertility preservation option for adolescent and adult men is sperm cryopreservation. Sperm can be frozen and stored for long periods of time, thawed at a later date and, used to achieve pregnancy with existing assisted reproductive technologies. However, sperm cryopreservation is not applicable for prepubertal patients who do not yet produce sperm. The only fertility preservation option available to prepubertal boys is testicular tissue cryopreservation. Next-generation technologies are being developed to mature those testicular cells or tissues to produce fertilization-competent sperm. When sperm and testicular tissues are not available for fertility preservation, induce pluripotent stem cells (iPSCs) derived from somatic cells such as blood or skin may provide an alternative path to produce sperm through a process call in vitro gametogenesis. This review describes standard and experimental options to preserve male fertility as well as experimental options to produce functional spermatids or sperm from immature cryopreserved testicular tissues or somatic cells.

Male fertility preservation and restoration strategies for patients undergoing gonadotoxic therapies