A teenager has become the first person in the UK to receive a testicular tissue transplant, in a procedure that could offer a pathway to fertility for boys whose sperm-producing cells are destroyed by cancer treatment.
The 19-year-old patient had testicular tissue removed and frozen three years ago, before undergoing chemotherapy for a serious blood disorder. After treatment, tests showed he had no sperm in his semen. In August, a team of NHS medics in Edinburgh transplanted the tissue back into his body.
“Fertility is something I've struggled with personally for a long time,” said the patient, who asked to remain anonymous. “I've always wanted to have children of my own but at some point, I found myself starting to slowly accept that that might never be possible for me. Having this procedure has given me genuine hope for the future.”
The student added: “We don't know yet whether it will work, but knowing that there is now even a possibility means more to me than I can really put into words. I'm incredibly grateful to everyone for giving me this opportunity and for all the work that has made it possible.”
The operation is the first of its kind in the UK and only the second reported worldwide. While freezing semen is an established fertility preservation method for older teenagers and adult men, it is not an option for pre-pubescent boys. The new treatment could open the door to fertility preservation for children undergoing cancer care and other treatments requiring chemotherapy.
The transplanted tissue contains spermatogonial stem cells, which are responsible for producing sperm from puberty onwards. Doctors should know within months whether the teenager is producing viable sperm.
The transplant, carried out by medics at NHS Lothian and backed by funding from Children with Cancer UK, follows a decade of research by the University of Edinburgh.
Rod Mitchell, professor of developmental endocrinology at Edinburgh's Institute for Regeneration and Repair and a consultant paediatric endocrinologist at NHS Lothian, said: “This is a big step towards helping boys facing treatments that damage their fertility to have children of their own. Ten years ago, we started our research programme to freeze and store pieces of testicle from boys before they start chemotherapy, to preserve their fertility. We are beginning to see some of these young men return to explore their fertility options. This study offers real hope for future fertility in boys facing cancer treatment.”
Tracey Gillies, medical director at NHS Lothian, described the operation as a “landmark procedure” and said it marked an important step forward for children whose fertility may be affected by treatment for serious illness. She added: “We are grateful to the patient and his family for helping.”