Spermatogonial Stem Cell (SSC) Transplant and Testicular Tissue Grafting
Spermatogonial Stem Cell (SSC) Transplant and Testicular Tissue Grafting
Spermatogonial stem cell transplantation through ultrasound guided rete testis injection and
 testicular tissue grafting will be performed for participants who have frozen testicular
 tissue prior to gonadotoxic therapy. The purpose of this study is to test the safety and
 feasibility of these transplant technologies and restore fertility for these participants.
Azoospermia (no sperm in ejaculated semen) impacts 1% of men in the general population and
 15% of infertile men, which translates to 645,000 males between the ages of 20 and 50 (prime
 reproductive years) in the United States. Spermatogenesis arises from a population of
 spermatogonial stem cells in the testes that maintain continuous sperm production throughout
 a man's post-pubertal life. Diseases or medical treatments that compromise the stem cell pool
 and/or prevent the stem cells from differentiating can cause infertility. Adult men have the
 option to cryopreserve a semen sample prior to therapy but this is not an option for
 prepubertal patients who are not yet producing sperm. This study will test the safety and
 feasibility of two approaches to restore sperm production using previously cryopreserved
 testicular tissues, which contain spermatogonial stem cells.

 The first approach is autologous transplantation of testicular cells, including
 spermatogonial stem cells, into the testis using ultrasound-guided rete testis injection. The
 second approach is autologous grafting of intact pieces of testicular tissue under the skin
 in the scrotum.
Inclusion Criteria:

 -  Male participant at least in Tanner stage 3

 -  Previously cryopreserved and stored testicular tissue/cells (frozen due to an
 infertility-risking diagnosis or treatment such as chemotherapy or radiation)
 available for autologous transplantation and grafting

 -  Healthy enough to undergo anesthesia

 -  Written clearance for the procedure from the patient's hematologist or oncologist to
 confirm the patient has finished treatment for primary condition and are clear to
 undergo autologous stem cell transplant

 Exclusion Criteria:

 -  Participants considered to be high risk for surgical complications

 -  Participants with a history of leukemia, lymphoma or testicular cancer or a cancer
 that likely involved testicles at the time of testicular tissue collection

 -  Diagnosed with psychological, psychiatric, or other conditions which prevent giving
 fully informed consent.