A man who survived childhood cancer has undergone the first known transplant of sperm-producing stem cells in a groundbreaking study aimed at restoring fertility in young cancer survivors.
Jaiwen Hsu, now 26, was diagnosed with bone cancer at age 11 after a leg injury. Doctors expected chemotherapy to save his life but warned it could leave him infertile. His parents enrolled him in a program at the University of Pittsburgh Medical Center, where researchers were freezing testicular cells from young boys with cancer to preserve their future fertility.
Now, as an adult, Hsu is the first to return and test whether reimplanting those cells could restore his fertility.
“The science is so new, it’s really a waiting game,” said Hsu, who lives in Vienna, Virginia. “We’re crossing our fingers and hoping for the best.”
While it may seem unusual to consider fertility during a child’s cancer treatment, 85% of children with cancer survive to adulthood. However, about one-third of these survivors are left infertile due to chemotherapy or radiation.
Young adults undergoing cancer treatment can store sperm, eggs, or embryos, but children diagnosed before puberty face more challenges as they don’t produce mature sperm or eggs.
Boys are born with stem cells in their testes that produce sperm after puberty. Kyle Orwig, a reproductive scientist at Pitt, studies how these cells could be preserved and used to restore fertility. His team has been collecting and freezing testicular tissue from prepubertal boys since 2011.
While it’s impossible to determine if each sample contains enough viable stem cells, Orwig’s team achieved a major milestone in 2019. They used preserved testicular tissue from a young monkey, leading to the birth of a healthy baby monkey.
In 2023, Orwig was ready to test this technique with human cells. When Hsu, curious about his earlier participation, contacted Orwig, the research team transplanted Hsu’s thawed cells in November 2023.
Orwig, however, remains cautious, emphasizing that the process is still experimental. A recent preprint published by Orwig on medRxiv reports that the cell transplant was safe and easy to perform, guided by ultrasound. However, since the work has not been peer-reviewed, the long-term success remains unclear.
Although it’s too early to confirm whether the transplant worked, Orwig’s team hopes that future research will encourage more families to consider fertility preservation for their children.
Similar studies are being conducted around the world. In January, researchers in Belgium transplanted pieces of testicular tissue into childhood cancer survivors. “These developments are very important,” said Dr. Ellen Goossens, a researcher at Vrije Universiteit Brussel. “Animal research showed promise, but human transplants will be the true test.”
Research on fertility preservation for female cancer survivors is also underway, with studies focused on immature ovarian tissue, according to Dr. Mahmoud Salama, who leads the Oncofertility Consortium at Michigan State University.
Hsu, while unsure of the experiment’s outcome, is grateful for his parents’ decision to preserve his fertility options. “Even if it doesn’t work, it will help future research,” he said. “I’m thankful they gave me the chance to make this decision for myself.”
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