Male Fertility Preservation in Non‐oncological Disease

Male fertility preservation has been widely used over the las tfew decades, and become one of the essentials of assis ted reproductivetechnology (ART).Currently, sperm cryopreservation is the mos t efficient approachin male fertility preservation using an ejaculated specimen.However, this option is inaccessible for patients withnonobs tructive azoospermia, ejaculatory dysfunction, and prepubertalpatients. Tes ticular tissue cryopreservation is available in certain pos t pubertal patients but remains experimental inpre-pubertal patients. There is promising data in animal modelsregarding tes ticular tissue and spermatogonial cells (i.e.SSCs) cryopreservation. The preservation of SSCs and tes ticulartissue is now being introduced at more centers. However,there are s till a considerable number of safety concerns withautotransplantation of tes ticular tissue. While fertility preservationis commonly used in cancer patients undergoing gonadotoxicchemotherapy, the indications for fertility preservation inmen have extended beyond the oncologic setting to include autoimmunediseases, gender dysphoria, Chronic medical condition, HIV positive , pre-vasectomy , pre-Surgical interventionswhich may result in direct damage to spermatogenesis, Pos thumoussperm retrieval, social sperm banking and even militarydeployment. Men exposed to toxins or those whose work conditionscan adversely affect spermatogenesis are also candidatesfor fertility preservation. Infertility in men with nononcologicalmedical conditions results primarily from exposure to gonadotoxicagents. Nonetheless, the underlying disease might alsocontribute to impaired sperm function.Cryopreservation is an essential process in fertility preservation;however, it can potentially damage sperm cell s tructureand eventually leading to impaired sperm function. Future researchshould look into techniques for improve the efficacy offertility preservation methods.On the other hand, early recognition of the potential need for fertilitypreservation is critical in order to provide patients with counselingand comprehensive information about fertility problems.