What are the fertility preservation options for young boys and adolescent males?

Children and young adolescent males present a unique opportunity and unique challenges to us as fertility preservation specialists. Obviously these are individuals who may or may not have much knowledge about reproduction, and nonetheless are going to be having cancer therapies. At this point in time, addressing fertility preservations in pre-pubertal males is something that would be regarded as being an experimental issue, and there are some centers in the United States that are looking for ways to preserve fertility in these men. The patients we focus on primarily clinically are those men, those young adolescents, who have gone through puberty, in other words, who have had at least one nocturnal emission, or wet dream. And those are patients who do have sperm production.
Obviously the diagnosis of cancer is devastating to the patient and his family, and oftentimes to the physicians as well. And the concept of looking at fertility preservation and the issues associated with obtaining a semen sample, may seem to be somewhat imposing or burdensome to a family unit and patient so distraught with this diagnosis of cancer that usually comes out of the blue. Nonetheless, we think it’s very important to make these families and their children aware of the option of fertility preservation, and this needs to be done in a very delicate, sensitive way. And a way I think that we actually are able to provide, a very comprehensive, compassionate, caring approach to these individuals. The discussion of semen collection with a teenage boy is not an easy discussion, typically, but again with a thoughtful approach and providing a reassuring environment, oftentimes we are able to help these patients produce a semen sample which can be used to preserve their fertility for use decades down the road.