Dr Rod Mitchell, University of Edinburgh
One of the major long-term effects of cancer treatment in young males is infertility. This project aims to establish a clinical service for preservation of testis tissue taken from pre-pubertal cancer patients for potential use to restore fertility in adulthood. This will be combined with a research programme investigating the effect of chemotherapy exposures on the pre-pubertal testis and the effectiveness of protective treatments.
Amount of grant: £249,435 | Date of award: May 2015
This project addresses a very important problem, namely fertility preservation in pre-pubertal males.
Currently, effective fertility preservation therapies are severely limited for this population of male oncology patients, and many of these patients will be rendered permanently infertile by their cancer therapies.
External reviewerSurvival rates for childhood cancer have increased dramatically over recent decades due to improved treatments for young patients. As a result, the long-term effects of cancer treatment are becoming an increasingly important consideration.
One important long-term effect of cancer treatment is infertility. For adult cancer patients, there is the possibility of storing sperm however for boys there are no options to preserve fertility because they do not yet make sperm.
Most of the studies that have investigated the effects of chemotherapy on the testicle are performed in adults and very few studies have involved children. It cannot be assumed that the effects are the same in children. Damage can result from effects on one of several cell types in the testicle and understanding how this occurs is important for developing new treatments to preserve or restore fertility.
In this project, Dr Mitchell and colleagues will establish a clinical service to store testicular tissue from boys with cancer at high risk of infertility. The tissue will be taken before they begin treatment and stored until they are adults so that it could be used to enable them to have children.
A small amount of the tissue taken from each patient will be used to carry out research to help understand how chemotherapy causes damage and affects fertility. The team will also test treatments that may prevent some of the damage that chemotherapy can cause.
About the research team
The research team is outstanding and has performed frontline research in this area.
External reviewerEdinburgh is at the forefront of fertility preservation in the UK. The team at the Centre for Reproductive Health leads an established programme for the freezing and storage of ovarian tissue from girls with cancer and in 2013 they became the first centre in the UK to obtain ethical approval for a fertility preservation programme in boys.
The expertise available in Edinburgh makes this the only centre in the UK where this combined clinical service and research programme can be established.
- Rod Mitchell, Clinical Research Fellow at the Centre for Reproductive Health and Honorary Consultant Endocrinologist at Edinburgh Royal Hospital for Sick Children, has a proven track record of research into development of the testicles.
- Hamish Wallace, Consultant Paediatric Oncologist, Edinburgh Royal Hospital for Sick Children, has vast experience in the care of young people with cancer, including assessment and counselling regarding fertility.
- Richard Anderson, Professor of Clinical Reproductive Science at the University of Edinburgh, is the lead for the female fertility preservation programme and has published widely on the subject of fertility preservation for children with cancer.
- Norah Spears, Professor of Reproductive Physiology, University of Edinburgh, has done a large amount of research into the effects of chemotherapy on the ovary.
This combination of expertise provides a unique opportunity to develop the field of fertility preservation for children with cancer.
What difference will this project make?
This project will offer short- and long-term benefits to the children involved in the study in addition to providing benefit to those diagnosed with cancer in the future.
Dr Mitchell’s team are the first in the UK to offer the possibility of storing testicular tissue from boys with cancer. The service will be offered to those boys whose treatment puts them at high risk of future infertility. The tissue will be available to these patients throughout adulthood to provide the potential long-term benefit of restoring their fertility in the future using techniques developed as part of this research.
Equally important, through their study of the mechanisms by which chemotherapy damages the testicle and causes infertility, the team will contribute to efforts to modify cancer treatments to reduce the risk of infertility for children diagnosed in the future. This will also aid the development of treatments that could help protect the testicles from chemotherapy-induced damage.
Read more: Treating childhood cancer | Long-term effects of treatment