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Introduction and Objectives: In the modern context, where fertility is crucial for couples, male factors contribute 40–50% to subfertility. Testicular cancer survivors facing subfertility due to treatments like orchidectomy and chemotherapy can benefit from sperm banking. However, awareness is lacking, especially in culturally sensitive Asian populations where sex and fertility discussions are taboo. This study aims to assess attitudes and utilization of sperm banking, evaluate its impact on pregnancy outcomes, and identify implementation obstacles. Materials and Methods: A phone interview survey targeted testicular cancer patients treated at Hospital Sultanah Aminah Johor Bahru and Sarawak General Hospital in Malaysia (2019–2023). Of the 102 identified patients, 62 participated. Investigators, using contact details from medical records, conducted interviews with a blend of quantitative and qualitative inquiries. Bivariate analysis identified factors linked to the decision to pursue sperm banking. Results: Out of 62 participants, 58.1% were aware of sperm banking, yet 90.3% chose not to utilize it. Reasons for declining included physician non-offer (41.1%), cost concerns (21.4%), a desire for prompt treatment (16.1%), lack of interest (14.3%), and other factors (7.1%). Among six patients opting for sperm banking, 50% utilized banked sperm, resulting in successful progeny for two-thirds. Notably, one case led to multiple pregnancies. Ethnicity (p = 0.046) and religion (p = 0.026) significantly influenced decisions, with Muslim Malays being the least likely to utilize sperm banking. Conclusion: Sperm banking emerges as a cost-effective strategy for safeguarding fertility in testicular cancer patients. Healthcare providers should proactively offer this option before treatment, ensuring patients are well-informed and addressing concerns to foster informed decisions.

Purpose: To investigate the occurrence of idiopathic secondary azoospermia (ISA) in men with oligospermia over time and identify risk factors for ISA in this population. Methods: This was a retrospective cohort study conducted in a university-affiliated male infertility clinic. A total of 1056 oligospermic men (concentration < 15 million/ml (M/ml) and no azoospermia) with at least two SA done between 2000 and 2019 were included. The primary outcome was the occurrence of ISA by oligospermia severity. Results: In the entire cohort, 31 patients (2.9%) eventually became azoospermic with time. The ≤ 1 M/ml extremely severe oligospermia (ESO) group (283 patients) had significantly higher rates of ISA in each time period compared to the 1–5 M/ml severe oligospermia (SO) (310 patients) and 5–15 M/ml mild oligospermia (MO) (463 patients) groups (p < 0.05 for all comparisons), with rates of 21.1% in the ESO, 4.8% in the SO, and 0% in the MO group (p = 0.02) after 3–5 years, reaching 32% after 5 years in the ESO group compared to no cases in the other two groups (p = 0.006). Parameters shown to predict ISA were initial concentration < 1 M/ml (OR 22.12, p < 0.001) and time interval of > 3 and 5 years (OR 4.83 and 6.84, p = 0.009 and < 0.001, respectively), whereas testosterone levels were negatively associated with ISA (OR 0.88, p = 0.03). Conclusions: Men with ≤ 1 M/ml, especially those with low testosterone levels, have a dramatically increased chance of becoming azoospermic with time. Therefore, sperm banking should be recommended in these cases. Men with a sperm concentration above 1 M/ml have low chances of becoming azoospermic, even after 3 or more years. [ABSTRACT FROM AUTHOR]

Purpose: A complication of cancer-directed therapy that often goes undiscussed is infertility. Although guidelines recommend addressing the possibility of infertility and fertility preservation approaches before initiating treatment, an internal review at our institution showed only 49% of female patients had infertility risk counseling documented. As a result, a fertility assessment communication was added into all oncology treatment plans to improve rates of fertility discussion and documentation. Methods: This retrospective observational study included newly diagnosed patients of childbearing potential who initiated cancer-directed therapy between January 1, 2020, and October 31, 2021. Patients who were no longer of childbearing potential due to age or surgery were excluded. Patients were divided into pre- and post-implementation groups to assess the impact of the fertility assessment communication implemented on November 1, 2020. Results: A total of 152 patients met inclusion criteria, with 80 patients in the pre-implementation group and 72 patients in the post-implementation group. The primary outcome of documentation of infertility risk discussion was 47.5% in the pre-implementation group and 86.1% in the post-implementation group (p < 0.0001). Discussion of fertility preservation options was documented in 28.7% of the pre-implementation group and 43.1% in the post-implementation group (p = 0.13). In the pre-implementation group, 5% underwent fertility preservation versus 27.8% in the post-implementation group (p = 0.0001). Of the 27 patients who received fertility preservation, 13 received hormonal therapy, 11 sperm banking, and 3 egg harvesting. Conclusion: This intervention significantly increased rates of infertility risk discussion and fertility preservation approaches received. There are opportunities to help patients receive fertility preservation, especially sperm banking and egg harvesting. [ABSTRACT FROM AUTHOR]

Résumé Contexte La cryoconservation des spermatozoïdes est une méthode efficace de préservation de la fertilité pour la congélation des spermatozoïdes liée à des causes médicales et aux demandes sociétales. Au total, 662 hommes (entre 15 et 65 ans; moyenne: 33,5 ± 8,8 ans) ont été inclus dans cette étude pour évaluer les caractéristiques de la population, la qualité du sperme et l’utilisation de la préservation autologue de spermatozoïdes réalisée par des patients à Beijing. Parmi ceux-ci, 351 étaient des patients atteints de cancer (53%; 31,1 ± 7,3 ans) et 311 des patients non atteints de cancer (47%; 36,1 ± 9,5 ans). Résultats Nous avons constaté que le nombre de cas de conservation a augmenté régulièrement de 2015 à 2019; 89,7% d’entre eux avaient un baccalauréat ou plus; 54,8%, 41,5% et 3,6% étaient respectivement célibataires, mariés, ou divorcés. Les cas de cancer et ceux d’oligozoospermie représentaient 71,3% de tous les patients; par conséquent, la plupart des patients avaient besoin d’une préservation de la fertilité pour raison de maladie. Le groupe des hommes atteints de cancer avait significativement une plus faible concentration de spermatozoïdes, un plus faible taux de spermatozoïdes progressifs après le test de congelation-décongelation, un plus faible nombre total de spermatozoïdes de motilité progressive après le test de congelation-décongelation, et un plus faible taux de récupération de spermatozoïdes mobiles progressifs (TRMP) que le groupe de patients non atteints de cancer (tous p

Simple Summary: Here we present a comprehensive review of the current literature describing mechanisms of damage incurred by cryopreservation, and we highlight several classical and novel strategies to mitigate this damage and increase sperm survival during the cryopreservation process. Cryopreservation is a way to preserve germplasm with applications in agriculture, biotechnology, and conservation of endangered animals. Cryopreservation has been available for over a century, yet, using current methods, only around 50% of spermatozoa retain their viability after cryopreservation. This loss is associated with damage to different sperm components including the plasma membrane, nucleus, mitochondria, proteins, mRNAs, and microRNAs. To mitigate this damage, conventional strategies use chemical additives that include classical cryoprotectants such as glycerol, as well as antioxidants, fatty acids, sugars, amino acids, and membrane stabilizers. However, clearly current protocols do not prevent all damage. This may be due to the imperfect function of antioxidants and the probable conversion of media components to more toxic forms during cryopreservation. [ABSTRACT FROM AUTHOR]

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Purpose: Infertility in adolescents and young adult (AYA) survivors of malignant disease remains a major long-term adverse effect, but semen collection for fertility preservation in fertility centers is not always feasible and makes AYAs uncomfortable. We evaluated the feasibility of collecting sperm samples on the ward versus in fertility centers. Methods: Consecutive hospitalized AYA-aged male patients in the Hematology AYA unit (Saint-Louis Hospital, France) between August 2010 and June 2016 with hematological disease and indication of semen collection (n = 95) were included in this retrospective study. Semen quality was analyzed according to World Health Organization guidelines and was compared according to semen collection place: on the ward (n = 46) or in fertility center (n = 49). Results: The median age was median age 19.1 years (range: 13.7–33.3; interquartile range: 17.1–22.8) and 85 patients successfully collected semen. Sperm collection failure was ∼11% and was comparable between the two modalities as were main sperm quality characteristics (semen volume, sperm concentration, total sperm count, progressive motility and vitality, sperm morphology, and multiple anomalies index). Oligospermia was significantly higher in the samples obtained in fertility center (47.7%) than on the ward (26.8%), p = 0.047. Average frozen straws were comparable, 12.2 ± 6.4 on the ward versus 11.9 ± 6.3 in fertility center. Conclusion: Semen collection on the ward is feasible and would be particularly interesting for AYA male patients without altering semen quality characteristics. [ABSTRACT FROM AUTHOR]

Purpose: To describe spermatozoa extraction rate by testicular sperm extraction (TESE) for posthumous sperm retrieval (PMSR) and examine harvest time impact on sperm motility; to compare long-term sperm usage between married vs. single deceased men. Methods: This retrospective study included all PMSR cases in Shamir Medical Center during 2003–2021. We evaluated sperm cryopreservation according to latency time after death. Then, we assessed sperm usage according to Israeli PMSR regulations. Results: The study included 69 (35 married and 34 singles) deceased men with average age of 30.3 ± 7.8 years. Sperm was cryopreserved in 65 cases (94.2%) after maximum and average harvest time of 40 and 16.5 ± 8.1 h, respectively. Motile sperm extraction was associated with significantly shorter harvest time compared with non-motile sperm (13.8 ± 7.3 vs. 18.7 ± 8.1 h, p = 0.046). Sperm usage among married deceased was significantly higher than single (15.6% vs. 0%, p = 0.05). Disposal requests were lower among single compared to married men relatives without reaching statistical difference. Eventually, single men had significantly higher rate of non-used cryopreserved samples (93.8% vs 69.6%, p = 0.01). Conclusion: This large long-term cohort study demonstrates high efficacy of PMSR. We found significant harvest latency time difference between motile and non-motile preserved sperm. Clinical sperm usage rate justifies the efforts for PMSR among married deceased. However, contradicting policy on the topic of single men (which implies liberal sperm preservation but rigid prevention of usage) results with high non-used sperm rate and relatives' extremely sophisticated emotional burden. [ABSTRACT FROM AUTHOR]

Cryopreservation is a way to preserve germplasm with applications in agriculture, biotechnology, and conservation of endangered animals. Cryopreservation has been available for over a century, yet, using current methods, only around 50% of spermatozoa retain their viability after cryopreservation. This loss is associated with damage to different sperm components including the plasma membrane, nucleus, mitochondria, proteins, mRNAs, and microRNAs. To mitigate this damage, conventional strategies use chemical additives that include classical cryoprotectants such as glycerol, as well as antioxidants, fatty acids, sugars, amino acids, and membrane stabilizers. However, clearly current protocols do not prevent all damage. This may be due to the imperfect function of antioxidants and the probable conversion of media components to more toxic forms during cryopreservation.

Male fertility preservation has been steadily increasing over the past two decades. Significant improvements have been achieved in the treatment modalities of cancer and other severe chronic medical conditions, leading to an increase in patient survivorship and the resulting demand for future parenthood. Recognition and proper patient counselling before commencing therapies with a potential gonadotoxic effect are of paramount importance. Similarly, nonmedically indicated fertility preservation is on the rise. Social sperm banking, gender dysphoria prior to affirmation procedures and posthumous reproduction preservation are becoming more common. When timing and logistics are appropriate, sperm cryopreservation is considered the gold standard for fertility preservation. Testicular tissue and spermatogonial stem cell autotransplantation is considered experimental and represents a promising alternative for pre‐pubertal patients. The current paper aims to review the recent trends in male fertility preservation, the common indications for sperm cryopreservation, techniques for sperm retrieval and experimental frontiers. [ABSTRACT FROM AUTHOR]

The prolonged lockdown of health facilities providing non‐urgent gamete cryopreservation—as currently recommended by many reproductive medicine entities and regulatory authorities due to the SARS‐CoV‐2 pandemic will be detrimental for subgroups of male infertility patients. We believe the existing recommendations should be promptly modified and propose that the same permissive approach for sperm banking granted for men with cancer is expanded to other groups of vulnerable patients. These groups include infertility patients (eg, azoospermic and cryptozoospermic) undergoing medical or surgical treatment to improve sperm quantity and quality, as well as males of reproductive age affected by inflammatory and systemic auto‐immune diseases who are about to start treatment with gonadotoxic drugs or who are under remission. In both scenarios, the "fertility window" may be transitory; postponing diagnostic semen analysis and sperm banking in these men could compromise the prospects of biological parenthood. Moreover, we provide recommendations on how to continue the provision of andrological services in a considered manner and a safe environment. Our opinion is timely and relevant given the fact that fertility services are currently rated as of low priority in most countries. [ABSTRACT FROM AUTHOR]

Purpose: In developing countries, a higher percentage of patients develop cancer at a younger age. Cancer survival rates have significantly improved, highlighting the importance of survivorship programs that address late complications related to cancer itself or its treatment. The purpose of this study is to estimate the prevalence of fertility counseling and sperm banking and related factors among at-risk males newly diagnosed with cancer and planning to receive a potentially curative anticancer therapy.Methods: Medical records and hospital database of young male patients with newly diagnosed cancers and planned to start chemotherapy were reviewed for fertility counseling and sperm cryopreservation. Additionally, a self-administered questionnaire was utilized.Results: A total of 186 patients, mean age 32.9 (range: 18-53) years, were included. Non-Hodgkin's lymphoma 59 (31.7%), leukemia 48 (25.8%), and Hodgkin's lymphoma 26 (14.0%) were the most common tumors encountered. A total of 129 (75.0%) respondents received fertility counseling prior to their treatment, and this rate was higher among patients with early-stage disease (82.4% vs. 58.1%, p = 0.038). However, sperm banking was performed by 33.1% of the whole study group but was significantly higher among single patients (53.4% vs. 17.7%, p < 0.001), those who had no children (51.8% vs. 14.3%, p < 0.001), and among highly educated patients (47.6% vs. 17.1%, p = 0.001). Patients failed to do sperm banking because they were not informed about the risk of infertility (26.2%) or service availability (25.4%). Fear of treatment delay was a reason in 20.0%.Conclusions: Fertility counseling and sperm banking among cancer patients are not optimal. Many patients failed to do sperm banking because of avoidable reasons. Better communication and patients' education will probably improve the utilization of this vital service. [ABSTRACT FROM AUTHOR]

Human sperm banking is an important procedure in the assisted reproductive technique centers. It entails sperm damage. The aim of this study was to investigate beneficial effect of Ceratonia siliqua (C. siliqua) supplement in freezing/thawing media on post thaw sperm parameters and sperm chromatin quality in normozoospermic samples. Forty normozoospermic specimens were included in this prospective study. Each sample was divided into ten groups. In groups one to five, 0 (as control group) 5, 10, 20 and 30 µg/ml C. siliqua were added to freezing medium and in groups six to ten, similar concentration of C. siliqua were added to thawing medium for 30 min incubation. Sperm concentration, progressive motility, normal morphology, viability, aniline blue (AB), toluidine blue (TB) and sperm chromatin dispersion (SCD) staining tests were evaluated before vitrification and after thawing. The results showed that 10 and 20 µg/ml supplementation of C. siliqua in freezing/thawing media significantly increased progressive motility, normal morphology and viability of sperm (p < 0.05) as well as decreased AB, TB and SCD (p < 0.05). Also, 20 µg/ml had significantly higher improvement compared to 10 µg/ml C. siliqua (p < 0.05). The present study showed that C. siliqua supplemented freezing/thawing media can improve sperm quality of normozoospermic samples after freezing/thawing. [ABSTRACT FROM AUTHOR]

The increasing maternal age at first birth is well recognized, but much less discussed are the fact that the prevalence of advanced paternal age (APA) is also increasing and the societal implications of this trend. Over the past 40 years in the United States, the proportion of infants born to fathers of APA, which has been variably defined as above 35 or above 45, increased from ˜4% to 10% (Khandwala et al., 2017, 2018) While there has been extensive research regarding infertility and comorbidities in the aging mother, relatively few studies have explored similar reproductive factors in aging men. However, evidence does suggest a decrease in fertility and an increase in pregnancy complications such as gestational diabetes, intrauterine growth restriction and preterm birth. Additionally, the offspring of fathers of APA have increased risks of chromosomal and non-chromosomal birth defects and an increased incidence of childhood autism and cancers. This review explores the data, with the intent that key counseling points, including the suggestion of sperm banking, can be highlighted when advising the midlife and older man who is considering paternity. [ABSTRACT FROM AUTHOR]

Semen cryopreservation is the recommended method for protecting the fertility of men before they undergo iatrogenic treatments. However, post-thaw sperm quality is highly variable between and within individuals. Thus, prediction of post-thaw quality has not been achieved with great certainty. Men (n = 101) attending our andrology clinic each produced a single ejaculate for semen analysis and semen cryopreservation. Post-thaw semen quality was examined for associations with traditional and novel semen and seminal plasma parameters. This current research demonstrates that the cholesterol concentration of human sperm is associated with ejaculate tolerance to cryopreservation. Corrected cholesterol, calculated as the difference between the cholesterol of semen and the cholesterol of cell free seminal plasma, is predictive of post-thaw motility. This may have potential as a method to guide the number of ejaculates stored for individual patients before iatrogenic treatment and/or for the appropriate selection of ART with frozen/thawed semen. [ABSTRACT FROM AUTHOR]

Purpose: As many as two-thirds of male childhood cancer survivors are at risk for fertility impairment as a consequence of treatment. Despite this, survivorship guidelines lack concrete recommendations as to when fertility status conversations should happen between patients and providers and what should be discussed. Thus, conversations may be inconsistent, or do not occur at all in survivorship. To inform recommendations for fertility-related conversations in survivorship, this pilot study aimed to better understand background (e.g., age, diagnosis and treatment intensity) and psychosocial factors (i.e., perceived barriers and perceived susceptibility) associated with survivor interest in learning about fertility status. Methods: Male survivors (N = 45) 15–25 years of age were recruited within 1–8 years of completing treatment. Survivors completed questionnaires based on the Health Belief Model (HBM) to assess perception of infertility risk and attitudes toward testing. Results: Most survivors (n = 31; 69%) reported they were informed of their risk for infertility by a healthcare provider before treatment, but only 31% (n = 14) of the sample banked sperm. Nearly two-thirds of survivors (n = 29; 64%) were interested in learning more about their fertility post-treatment. This interest was significantly correlated with greater perceived susceptibility to infertility by survivors, but it was not associated with other psychosocial or background factors. Conclusion: Informing survivors of their personal infertility risk may increase interest in pursuing testing. Offering opportunities for fertility testing and family planning alternatives may mitigate potential psychological distress and unplanned pregnancy. While additional research is needed, future survivorship guidelines should encourage regular communication about fertility status and offer fertility testing for male survivors. [ABSTRACT FROM AUTHOR]

Background: Cancer survivor rates have increased over the past few decades leading to a growing interest in research related to quality of life (QoL). We attempted to explore the unique barriers that might prevent adult male cancer patients from accessing sperm cryopreservation in Pakistan. Methods: Semi-structured interviews of male cancer patients aged 18–45 years were audio-recorded in Urdu and translated to English and were transcribed ad verbatim. The topics included information regarding risk of infertility following chemotherapy, future reproductive choices, and barriers to sperm cryopreservation. Questionnaire to physicians containing four content domains of knowledge, attitude, practice, and barriers to sperm banking was also delivered. Data were entered and analyzed on SPSS. Results: Of the 25 patients interviewed, there were 10 cases of leukemia, 3 cases of lymphoma, 2 cases each of colorectal carcinoma and multiple myeloma, 1 case each of neuroblastoma and osteosarcoma, and solitary cases involving the lung, breast, thymus, brain, jaw, and testis. Four patients knew about the risk of infertility. All patients were aware of the option of sperm cryopreservation. Two patients had their sperm preserved before the initiation of chemotherapy. Perceived treatment-related expenses appeared to be the major barrier to sperm cryopreservation in nine patients. This was followed by lack of information, which was cited by eight patients, and religious reasons (n = 2 patients). Other barriers were female gender of the doctor and patient's preferences. Four patients stated no barriers. Nine physicians responded to the questionnaire. Seventy-eight percent of physicians agreed that cancer treatment increases the risk of infertility. 33.3% strongly agreed and 55.6% agreed that infertility can have an adverse impact on QoL. Conclusions: There is a significant lack of awareness among male cancer patients regarding infertility following cancer treatment. It is imperative that physicians inform them of this and discuss treatment options, along with addressing potential barriers. [ABSTRACT FROM AUTHOR]

Objective: To describe fertility-related informational needs and practices, and to examine if demographic characteristics are related to these needs and practices.Methods: A needs assessment survey was conducted at three Canadian cancer centres.Results: 192 male cancer patients (Mage = 33.6) completed the survey. Most patients (70%) recalled having had a discussion with a health care provider regarding their fertility and 44% banked their sperm. Patients reported not getting all the information that they wanted, eg, the risk that a future child may have the same type of cancer (78%), and what was covered by insurance plans (71%). Barriers to sperm preservation were urgency to begin cancer treatment (49%), not planning to have a child in the future (47%) and worries that cancer could be passed on to future children (38%). Participants' age and being the parent of a child were significantly associated with having had a discussion about fertility. Participants' age, province, being the parent of a child and the desire for future children were significantly associated with fertility preservation.Conclusions: Discussions with health care providers were more frequent, and fertility preservation rates were higher than in past studies, but still not all patients' questions were answered. Misconceptions about passing on cancer to one's child, and that sperm preservation will delay treatment, should be dispelled. Health care providers can ask patients if they have any desire to have children in the future as a way to initiate a discussion of fertility preservation. Key information gaps and psychosocial resource needs are suggested to fully meet male cancer patients' fertility-related concerns. [ABSTRACT FROM AUTHOR]

Objectives: Awareness and acceptance of transgenderism have increased in the last two decades. There is limited literature regarding the incidence and semen characteristics of transwomen banking spermatozoa. We sought to assess the incidence of sperm cryopreservation of transgender individuals compared with the cisgender population in the last 10 years. Semen parameters were also compared between the two groups. Materials and methods: We performed a retrospective analysis of sperm cryopreservation performed at a single center from 2006 through 2016. Using available data on indications for banking and prior hormonal therapy status, we isolated healthy transgender and cisgender cohorts for semen parameter comparison. Linear regression was used to compare the incidence trends. Semen parameters were compared using the generalized estimating equations method. The rates of semen parameter abnormality of each group were compared using chi‐square test. Semen parameter abnormalities were defined using WHO 2010 reference values. Results: We analyzed 194 transgender samples and 2327 cisgender samples for a total of 84 unique transgender sperm bankers and 1398 unique cisgender sperm bankers. The number of transgender sperm bankers increased relative to cisgender sperm bankers from 2006 to 2016. Following exclusion of cisgender sperm bankers with health issues that might impact semen quality and transgender sperm bankers with known prior hormonal therapy, we compared the semen parameters of 141 healthy cisgender sperm bankers and 78 healthy transgender sperm bankers. The transgender sperm bankers demonstrated lower sperm concentration, total motile sperm count, and post‐thaw sperm parameters. The transgender sperm bankers also demonstrated a higher incidence of oligozoospermia. Conclusions: This is the largest report to date on the incidence of transgender sperm cryopreservation and comparison of semen characteristics with cisgender sperm bankers. The data reveal an increased incidence of transgender sperm banking as well as poorer semen parameters of transgender individuals compared with cisgender controls. [ABSTRACT FROM AUTHOR]

This research deals with the issue of sperm banks. It discusses the arguments for and against their establishment. It aims to elaborate the jurisprudential ruling on the requirements and regulations of sperm banks. The research follows an analytical approach in presenting and discussing evidences, and an inductive approach in surveying the history, purposes and regulations of sperm banking, and a typical fiqhi / jurisprudential approach in presenting rulings with evidences and proper documentation of Hadiths and other sources. Among the research's important findings are the following: related rulings depend on the type of guarantees put forward by the institutions responsible for the bank activities; if the institutions fulfill the stated requirements and regulations, the sperm banks are highly likely to be ruled as permissible, and vice versa. To be Islamically permissible, it is required that the aim of storing the sperms be to conduct artificial insemination for a legally married couple in their lifetime, providing the husband's consent; it is also required that no harm befall the fetus as a result, and that meticulous care be taken in related banking activities and operations to guarantee safety and identity; those in charge of sperm banking activities have to be well known for their integrity and expertise; and the whole project has to be under state control.

Background Advances in cancer treatment have led to improved long-term survival after childhood cancer, but often at a price of impaired future fertility. Fertility preservation ( FP) in male children and early adolescents poses unique challenges as efficacy is unproven. Objectives To describe characteristics of testicular tissue cryopreservation ( TTCP) specimens taken from paediatric and adolescent patients, stratified by age, and prior chemotherapy, if any, and to demonstrate evidence for germ cells. Materials and methods Retrospective review of gonadal biopsies and clinical records of patients consented into the Royal Children's Hospital FP programme between 1987 and 2015. Tissue was sliced into blocks, with one section sent for histopathology prior to cryopreservation. In boys ≥12 years where spermatogenesis could be expected, a portion of tissue was disaggregated completely to look for mature sperm and if found, additional tissue was dissected and the resulting suspension frozen. Results Testicular tissue cryopreservation specimens in 44 males (0.3-16.8 years) provided an average of 7.8 slices per patient. All the specimens were taken at the same time as another necessary surgical procedure, under one general anaesthesic. There was only one complication of scrotal wound dehiscence. Seven of the forty-four (15.9%) patients had chemotherapy prior to testicular biopsy, while the rest were chemotherapy naïve. Five of these were prepubertal, and two were pubertal patients. Eleven subjects had tissue dissected with mature sperm found in eight. Of these eight patients where sperm were found, all were pubertal with testicular size of more than 10 mL and showing histological evidence of spermatogenesis. No histologic specimen demonstrated any malignant cells. Conclusions Testicular tissue cryopreservation can be performed in young patients without delay, preferably prior to cancer treatment. As testicular tissue contains germ cells from which haploid spermatozoa are ultimately derived, future technologies may allow their utilization for fertility in humans. This may be the only hope for biological offspring in some patients undergoing fertility compromising treatment. Retrieval of mature sperm from some pubertal patients, however, offers realistic hope to these patients of future fertility. [ABSTRACT FROM AUTHOR]