Department of Urology | Why Choose Us? | Fertility Preservation

Once your child is referred to us, we will work hand-in-hand with you and your physician as you learn more about your child's condition and determine the possibility of fertility preservation. Treatment may involve close observation, medical therapy, surgery or both. We then provide long-term follow up with our experienced staff to ensure your child has options as an adult.

Pediatric male fertility preservation

There are several conditions where fertility consultation may be considered for your son.

Cancer

In males newly diagnosed with cancer, future fertility should be considered since some treatments are associated with long-term effects on sperm production and may lead to infertility. Options for preserving fertility before cancer treatment are available for pre-pubertal and pubertal males. For more information visit Dana-Farber/Boston Children's Cancer and Blood Disorders Center.

Ambiguous genitalia and disorders of sex development

Boston Children's physicians are adept at diagnosing and treating children born with ambiguous genitalia. As part of their comprehensive care, each patient is assessed for fertility potential and some may benefit from fertility preservation. Treatment of sex development issues may involve hormone supplementation, surgery or both. Patients with disorders of sex development are seen in conjunction with our Pediatric Endocrinology team in the Gender Management Service (GeMS) clinic.

Klinefelter’s syndrome

Klinefelter’s syndrome is a condition that occurs in approximately 1 in 500 newborn males. These boys are born with an extra X chromosome that can affect growth, learning ability and testicle function. A recent Boston Children’s study on adolescents with this condition demonstrated that sperm can be surgically retrieved from these young men at rates similar to that in adults. However, the fertility preservation procedure should be reserved until these patients are ready to start families of their own.

Fertility preservation treatment options for males

There are several treatment options for your son depending on pubertal maturity and related condition(s).

Observation

Depending on the treatment received, some boys will have an excellent chance of recovery of testicular function. A good option for these boys may simply be to allow enough time for sperm production to restart. When boys become men, if they have issues with fertility due to inadequate sperm production, specialists in male infertility and reproductive endocrinology will be available to assist them.

Sperm banking

Sperm banking is offered to all eligible males at risk for infertility who have demonstrated pubertal changes (typically 13 years old or more). Adolescents who are capable of producing a semen sample by self-stimulation can have the sample preserved for future use. This is recommended for boys that are going to receive therapy that has a chance of causing permanent damage to sperm production.

Testicular sperm extraction and banking

All eligible male patients at risk for infertility who have undergone puberty but are unable to produce a semen sample may also preserve sperm. A surgical biopsy of the testicle can be performed to obtain a sample of tissue with active sperm production. The sperm can then be extracted for preservation.

Testicular tissue banking

Boys that have not entered puberty do not produce sperm. But, their testicles contain cells that are essential for sperm production later on. These testicular stem cells can be affected by some therapies.

Testicular tissue freezing is a preservation option that can be performed before puberty, but it is considered experimental since the technology to use this tissue to restore fertility has not been developed thus far. In this procedure, small pieces of testicular tissue are surgically removed before cancer treatment and frozen for future use.

Pediatric female fertility preservation

Boston Children’s works closely with your child’s medical team to ensure that fertility consultation and discussion of female preservation options are integrated into the patient and family education of all newly diagnosed patients.

Learn more about fertility preservation at the Brigham and Women’s Hospital Center for Infertility and Reproductive Surgery and the Dana-Farber/Boston Children's Cancer and Blood Disorders Center Fertility Preservation Program.

International patients

For families residing outside of the United States, please contact Boston Children's International Health Services, which facilitates the medical review of patient records and appointment scheduling and which provides assistance with customs and immigration, transportation, hotel and housing accommodations.