A 9-year-old boy has become the first person in Britain to have testicular tissue frozen as a means of preserving fertility later in life.
Nathan Crawford, who has a brain tumor, underwent the procedure following fears that his chemotherapy and radiotherapy treatments would affect his ability to have children. The tumor—a glioma, stemming from the glial cells which support the brain’s nerve cells—is too close to the organ’s vital tissue to be operated on without major damage being caused.
Surgeons at John Radcliffe Hospital (JRH) in Oxford, England, were responsible for the keyhole operation—which lasted just 30 minutes—during which they removed an orange segment-like wedge of tissue from Nathan’s testes. Similar to the process used to freeze ovarian tissue, it is taken out and then divided into small parts for freezing.
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“You are storing the tissue which contains the stem cells,” explained Dr. Sheila Lane, clinical lead for tissue cryopreservation at JRH. “What happens when you put this tissue back, at a later date, is that it generates its own blood supply and starts producing normal hormones, which restores fertility.”
“These tumors can possibly be cured with intensive chemotherapy,” she said. “Patients can have a long and happy life without any problems,” Dr. Lane added. The technique has also been shown to work in animals.
Nathan’s family first realized something was wrong after he “was having more headaches than you would expect and also had blurry vision, which we initially put down to too much time on the games console or possibly problems with his eyesight,” his stepfather Jonathan Alison said. He was taken to an optician, who sent Nathan straight to a doctor, and within a few days, he was having fluid surgically removed from the brain.
A biopsy of the tumor followed, which revealed that it was a grade two, non-cancerous growth, but “with this type of tumor, as a child gets older it will quite often grow. It could cause damage that could be life-threatening,” Alison explained.
The hospital was able to offer storage for Nathan’s cells, which led the family to decide on his undergoing chemotherapy, and “once he’d been up to Oxford to have the tissue removed, he was back home in Cornwall within 48 hours eating fish and chips with us.”
The surgeons estimate that there is an “80 percent chance” Nathan will need the tissue later in life, which could make him the first to reproduce using the stored matter. No live births have yet been recorded from frozen testicular tissue, but a woman in Belgium gave birth last year after using previously frozen ovarian tissue that was extracted when she was undergoing cancer treatment at age 14. Implanted back into her ovaries a decade later, she became pregnant at 27, offering hope to the thousands of children who undergo cancer treatment each year.
For young boys who are diagnosed with cancer, sperm banking—the most common form of preservation— isn’t an option, as they have not begun producing sperm. The procedure becoming more commonly available will also alleviate the tough choice over whether young cancer sufferers should undergo infertility-inducing therapies.
"Every year, thousands of parents who receive the devastating news that their child has cancer can then face additional worries that their child’s life-saving treatment could leave them unable to have their own family,” said Kate Lee, chief executive of children’s cancer charity CLIC Sargent.
“Although at this early stage it is difficult to predict how successful this new technique will be, it is certainly a fantastic opportunity for the young boy and family involved, and a positive step forward,” Lee said.
