30 timestamped statements
across 1 topic
— auto-found in recorded discussions, each timestamp jumps to the exact moment.
Summaries Shrine gave as host are listed separately below.
Featured statements
▶Ep 64 · 9:00
testicular tissue cryopreservation relies on the future development of technologies in order to allow for the maturation of spermatogonial stem cells into mature sperm that can be used for fertilization and eventual pregnancy
fertility preservation before puberty is much more of a challenging issue to address, particularly in males where you have a limited ability to do or no ability to do sperm cryopreservation
Options for Male Fertility Preservation: Pediatric Oncofertility 2017
▶Ep 64 · 0:08
clinicalThe testes has a greater chemo and radio sensitivity than the ovaries.↗
▶Ep 64 · 0:08
clinicalChemotherapeutic agents used for pediatric cancer treatment readily cross the blood testes barrier and primarily affect cells undergoing spermatogenesis due to their high mitotic rate.↗
▶Ep 64 · 0:08
clinicalLeydig cells that produce testosterone are less sensitive to chemotherapy but can have sensitivity to radiation at very high doses.↗
▶Ep 64 · 0:08
clinicalMales have no protective effect of receiving treatment at a younger age, which differs from females.↗
▶Ep 64 · 0:08
clinicalRetroperitoneal lymph node dissections for testicular cancer can damage sympathetic nerves that control antegrade ejaculation, leading to fertility issues.↗
▶Ep 64 · 0:08
quotemales have no protective effect of receiving treatment and having exposure at a younger age, which doesn't seem to be the case in females↗
▶Ep 64 · 0:08
quotethe testes has a greater chemo and radio sensitivity than the ovaries↗
▶Ep 64 · 3:00
quotethe quality of semen analysis and DNA integrity can be compromised after even a single course of treatment↗
▶Ep 64 · 3:00
quotewe really don't recommend age to be considered in isolation when deciding whether to offer sperm cryopreservation to a patient↗
▶Ep 64 · 3:00
quotestage of puberty development is a better, um, indicator to mark you than age↗
▶Ep 64 · 3:00
quotesperm cryopreservation is the most established option for fertility preservation↗
▶Ep 64 · 3:00
clinicalElectroejaculation with insertion of a probe into the rectum can harvest a specimen and needs to be performed under general anesthesia.↗
▶Ep 64 · 3:00
clinicalSperm cryopreservation should be offered prior to treatment, as the quality of semen analysis and DNA integrity can be compromised after even a single course of treatment.↗
▶Ep 64 · 3:00
opinionStage of puberty development (typically Tanner stage 3 or above) is a better indicator than age for determining when to offer sperm cryopreservation.↗
▶Ep 64 · 6:20
clinicalTesticular sperm extraction (TESE) involves retrieval of sperm from focal areas of spermatogenesis in the seminiferous tubules for later use with ICSI.↗
▶Ep 64 · 7:26
quotethey were only able to actually find successful, um, sperm that they could use later for ICSI in those percentages. So, um, it's almost a fifty-fifty chance on average on whether it's successful, but these are patients that really have no other option because they're zoospermic when they're providing a semen specimen↗
▶Ep 64 · 7:45
clinicalMicroscopic assistance in TESE allows better identification of tubules that potentially contain sperm and has improved retrieval rates in adult literature.↗
▶Ep 64 · 8:01
quoteit has in the adult literature. There's really nothing in terms of the pediatric literature in terms of improving sperm retrieval rate, but it has in the adults↗
▶Ep 64 · 9:00
quotetesticular tissue cryopreservation relies on the future development of technologies in order to allow for the maturation of spermatogonial stem cells into mature sperm that can be used for fertilization and eventual pregnancy↗
▶Ep 64 · 9:00
quoteNo successful retrieval of mature sperm or pregnancies have been reported to date↗
▶Ep 64 · 9:00
clinicalFertility preservation before puberty in males is challenging due to the absence of mature sperm that can be cryopreserved.↗
▶Ep 64 · 9:00
clinicalPreserving fertility in prepubertal males is contingent on future development of experimental therapies for maturation of spermatogonial stem cells to sperm.↗
▶Ep 64 · 9:00
clinicalSpermatogonial stem cell therapies developed in animal models include direct transplantation into the testicle, transplantation of testicular tissue as autologous or xenograft, and in vitro sperm maturation, but none have been performed successfully in humans.↗
▶Ep 64 · 9:00
clinicalTesticular tissue cryopreservation involves harvesting immature testicular tissue prior to treatment initiation and cryopreservation with slow freezing techniques.↗
▶Ep 64 · 9:00
clinicalAt Cincinnati Children's, testicular tissue cryopreservation eligibility includes pediatric males 6 months to 17 years with >80% risk of long-term azoospermia, and adults 18-25 years with 21-79% risk.↗
▶Ep 64 · 9:00
clinicalThe excisional biopsy is coordinated with other surgical procedures to minimize anesthetic risk and expedite treatment initiation, performed through a transscrotal approach.↗
▶Ep 64 · 9:00
clinical75% of harvested testicular tissue is stored at Reprotech for patient use and 25% is designated for research at McGee Women's Research Institute.↗
▶Ep 64 · 9:00
clinicalNo successful retrieval of mature sperm or pregnancies from cryopreserved testicular tissue have been reported to date in humans.↗
▶Ep 64 · 9:00
quotefertility preservation before puberty is much more of a challenging issue to address, particularly in males where you have a limited ability to do or no ability to do sperm cryopreservation↗
▶Ep 64 · 9:00
quotenone of these technologies have actually been performed successfully in humans at this point↗
Summaries Shrine gave as host
· 14 summaries
Recaps of what the experts said, with Shrine as narrator — not Shrine's own clinical position, and never cited in answers.
Summaries Shrine gave as host · Pediatric Oncology14 summaries
Options for Male Fertility Preservation: Pediatric Oncofertility 2017
▶Ep 64 · 3:00
host summaryShrine summarizing the discussion: azoospermia, which is the absence of sperm, was present in only 16.9% of untreated patients versus 84% of patients who were treated and then subsequently tried to perform sperm cryopreservation↗
▶Ep 64 · 3:00
host summaryShrine summarizing the discussion: in the youngest age group between 11 to 14 years of age 65% of the patients were able to successfully sperm bank, which is a fairly high percentage↗
▶Ep 64 · 3:00
host summaryShrine summarizing the discussion: In the Philadelphia study, semen volume, total motile count, and rate of azoospermia improved with increasing age on both univariate and multivariate analysis.↗
▶Ep 64 · 3:00
host summaryShrine summarizing the discussion: In the youngest age group (11-14 years), 65% of patients were able to successfully sperm bank.↗
▶Ep 64 · 3:00
host summaryShrine summarizing the discussion: The mean and median semen volume, concentration, and motility in the adolescent cohort were greater than WHO criteria derived from fertile adult males.↗
▶Ep 64 · 3:00
host summaryShrine summarizing the discussion: The American Society of Clinical Oncology recommends that sperm cryopreservation should be offered to all peri and postpubertal adolescents who are able to provide a semen specimen.↗
▶Ep 64 · 3:00
host summaryShrine summarizing the discussion: In a Philadelphia cohort, azoospermia was present in only 16.9% of untreated patients versus 84% of patients who were treated and then subsequently tried to perform sperm cryopreservation.↗
▶Ep 64 · 3:00
host summaryShrine summarizing the discussion: Several centers have demonstrated successful sperm banking in greater than 80% of patients, with a median of 1.5 attempts and 7 samples per patient.↗
▶Ep 64 · 3:00
host summaryShrine summarizing the discussion: Studies have shown that adequate semen specimens can be obtained in adolescents as young as 11 years of age.↗
▶Ep 64 · 6:20
host summaryShrine summarizing the discussion: Sperm was successfully extracted from an adolescent as young as 11 years of age, but not from any child below Tanner stage 3 development.↗
▶Ep 64 · 6:20
host summaryShrine summarizing the discussion: Successful sperm retrieval with TESE has been reported in 47% of patients prior to chemotherapy and 37-65% after chemotherapy.↗
▶Ep 64 · 6:20
host summaryShrine summarizing the discussion: In a study subset of adolescents and young adults aged 11-19 years, 33% sperm retrieval rate was reported prior to treatment.↗
▶Ep 64 · 6:20
host summaryShrine summarizing the discussion: they weren't able to do it in any child that was below 10 or stage 3 development↗
▶Ep 64 · 9:00
host summaryShrine summarizing the discussion: Studies have demonstrated high satisfaction and acceptance of risk for testicular tissue cryopreservation among patients and families.↗
