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Fertility Preservation in Children

Our center offers the most comprehensive approach to fertility preservation in children in the world. Depending on the age and gender of the child, whether she/he is pre or pospubertal, a different approach is taken. This is not only for cancer patients but any time a genetic, metabolic or familial condition exists that can threaten future fertility and cause gonadal failure. Often times children need bone marrow transplants for cancer and other conditions and the chemo treatments preceding the bone marrow transplants nearly guarantee gonadal failure. In Turner’s syndrome, girls run out of their eggs and become menopausal many time even before experiencing puberty. These and other medical indications often prompt fertility preservation in children. The main types of approaches to fertility preservation in children are as follows:

In girls:

Ovarian freezing can be performed at any age children, but egg freezing may also be possible in some case scenarios.
If prepubertal  the only approach is ovarian tissue freezing as no sexual maturity is required.The procedure can be done even in newborn babies in conjunction with pediatric surgeons.

If postpubertal and at least 13 years of age, ovarian stimulation and oocyte cryopreservation can also be attempted. We have successfully cryopreserved oocytes from children at 13 years of age.

If postpubertal and under the age of 13, we typically perform ovarian tissue freezing because ovarian stimulation and required follow up may not be practical in this young children.

In boys:

If postpubertal sperm freezing is a routine and a successful procedure. Even a single collection maybe sufficient, as with the advent of intracytoplasmic sperm injection (ICSI) single sperm can be injected into future partner’s eggs.

If prepubertal, testicular biopsies can be frozen for future transplantation. This is a <30 min outpatient procedure which only requires a small incision to the scrotal skin. Once the testicular biopsy is obtained, it is frozen with a specialized process. In the future this frozen tissue which contains immature precursors of sperm producing cells may be used for restoring fertility of the, now adult, child. Testicular grafting is considered experimental as no attempts have yet been made to test the success. We are one of the very few centers around the world to perform this procedure. It is also performed under an experimental protocol approved by New York Medical College Institutional Review Board.

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