Rapid advances in technology and treatment have produced cancer’s new reality — many more people will survive the disease and go on to live full productive lives. In fact, scientists estimate that by the year 2020, one in every 200 men will be an adult survivor of a childhood cancer.
But for some, surviving cancer has its own sacrifices. Cancer treatments target the defining characteristic of oncologic disease — rapid uncontrolled cell division. Among the casualties of treatment are so-called “good cells” such as spermatogonial stem cells, the adult tissue stem cells that produce sperm. For some male cancer survivors that means permanent infertility. No one questions that curing cancer is the priority, whatever the cost. Now, biologists at Magee-Womens Research Institute (MWRI) are testing a technique that would mean men won’t have to sacrifice their future ability to have their own children in order to survive cancer.
AT RIGHT: Kyle Orwig (left) and a team of MWRI researchers are pioneering a technique to preserve future fertility in cancer patients.
For Kyle Orwig, PhD, who is leading the MWRI team testing the spermatogonial transplantation technique, the prospect that his biological research could make such a significant impact on human health is a motivating force. Such meaningful scientific research has driven him across the country from Oregon to Kansas, and later to the University of Pennsylvania, where he worked in the research laboratory that invented a technique for transplanting spermatogonial stem cells to restore fertility. He came to Magee to continue that research.
Spermatogonial transplantation involves removing spermatogonial stem cells from a boy or man before he undergoes cancer treatment and preserving those cells to be transplanted back to him at a later time. The technique has proven successful in the laboratory, so now the team is translating what they’ve learned from rodent models to species with greater relevance to human physiology.
“Fertility is an incredibly desperate concern,” Dr. Orwig explains. “Reproductive issues are significant contributors to quality of life for most people. While adult men have alternative fertility preserving options, such as cryopreserving semen followed by in vitro fertilization, this option is not always offered at the time of diagnosis and some men are not able to deliver an adequate sample due to their cancer. Furthermore, there are no fertility preserving options for preadolescent boys who are not yet producing sperm. By preserving spermatogonial stem cells prior to treatment, male cancer survivors may one day have access to new fertility preserving options.”
Dr. Orwig and the MWRI team continue to refine and optimize the transplantation technique using ultrasound guidance, as well as enrich spermatogonial stem cells and remove undesirable cells. “I truly believe that the regenerative potential of spermatogonial stem cells can be exploited to treat male infertility,” he says. “Now it is important to facilitate discussions among patients, cancer doctors, reproductive specialists, and scientists about future options on the fertility preservation frontier.”
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