A teenager has become the first patient in NHS history to have his fertility preserved following chemotherapy treatment. The pioneering surgery involved medics transplanting the individual’s own testicular tissue back to him.
The tissue was taken and frozen in 2023, when the boy was aged 16. He then underwent chemotherapy which was needed ahead of a bone marrow transplant for a serious blood disorder.
Landmark transplant procedure
In August this year, three years after the chemotherapy, the tissue was transplanted back in the hope that he will be able to produce viable sperm again. The procedure has only happened once before, in Belgium, with the patient now producing sperm.
This case is the first time anyone in the UK has had the procedure performed. The teenager, now 19, said that it had given him "hope for the future".
Potential breakthrough in male fertility
The University of Edinburgh described the treatment as a "potential breakthrough in male fertility preservation". Chemotherapy can permanently destroy cells needed to create sperm, leaving children who have treatment at risk of infertility later in life.
Freezing semen is an established fertility preservation method for teenage boys and adult men. But for pre-pubescent boys this is not an option so the new treatment potentially opens a door for fertility preservation for children needing cancer care and other treatments which require the use of chemotherapy.
Research and next steps
The testicular tissue taken for transplant contains so-called spermatogonial stem cells, which are responsible for producing sperm from puberty onwards. Medics should know in a matter of months whether the procedure has enabled the 19-year-old student to produce viable sperm.
The procedure, carried out by NHS Lothian and supported by funding from Children with Cancer UK, could only happen after a decade of research by experts at the University of Edinburgh. The University said the teenager has recovered well after the procedure. In the spring, some of the transplanted tissue will be removed and examined to determine whether sperm have been produced, it added.
The UK-based patient said: "Fertility is something I’ve struggled with personally for a long time. 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," he 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. I also hope that being part of this research means that, in the future, other young people in the same position can have that hope too."
Study lead Rod Mitchell, professor of developmental endocrinology at the University of Edinburgh’s Institute for Regeneration and Repair and 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," he added. "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."
More than 1,200 patients in the UK have now had testicular tissue stored for potential future use, the University said.
