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Baylor urologists test fertility treatment for men after cancer
By John Tyler

Larry Lipshultz, MD

Could men undergoing chemotherapy or radiation therapy for cancer soon have the possibility that their fertility could be restored after beating the disease?

Work underway in the Baylor College of Medicine Laboratory for Male Reproductive Research and Testing may soon revolutionize how fertility physicians around the globe care for those men with cancer.

"Depending on the amount of radiation or chemotherapy, men are often sterile after treatment," said Larry Lipshultz, MD, a professor in the department of urology. "It is our hope that soon men can regain their fertility after treatment."

Using an animal model over the past five years, Baylor researchers led by Dolores Lamb, PhD, an associate professor in the departments of urology and molecular and cellular biology, have had positive results by taking biopsies of the testes, extracting sperm, and isolating the adult stem cells. The stem cells are then injected back into the testes of an infertile recipient animal that lacks the ability to produce sperm to see if repopulation and restoration of spermatogenesis (the process of producing sperm) is possible. They have found sperm production is occurring.

Researchers hope to soon use this same procedure in humans to give men a chance to establish their family after the cancer is gone. "Patients will have a biopsy before their radiation or chemotherapy," Lipshultz said. "After they recover from the cancer, the stem cells from that biopsy will be injected back into the testes."

Kirk C. Lo, PhD, left, and Delores Lamb, PhD, examine a tissue sample.

At this time, Lamb and her research team are developing technologies that would improve the purity of the testicular stem cells. "The testes can be reservoirs for lymphomas or other cancer cells and we need to perfect a way to purify the samples we take from these patients before we can safely perform these transplant procedures in humans."

Lamb called the prospect of accomplishing this goal "very promising," and said we are only years away from a breakthrough. "It's really just a matter of time," she said. "I really think that within five to 10 years, we will see a big difference in how we treat these patients."

Lamb drew an analogy of a seed and soil to describe the breadth, and limits, of the work. "The soil is the Sertoli cell (the nurse cell in the testis that supports and nurtures sperm cells during their development)," she said. "It is a key player, and if it is damaged there is really nothing we can do to restore that."

"However, we are concentrating on the seed, or the spermatogenic stem cells," she said. "If by injecting these stem cells back into the testes we can get the seed to repopulate the testis, we will have been successful."

This therapy will give men an alternative to visiting a sperm bank before cancer therapy.

"We've been banking sperm for men diagnosed with cancer for years and that has always given couples the opportunity to have children once they beat the cancer," Lipshultz said. "However, if this new therapy proves to work the way we feel it may in humans, it will allow couples to conceive naturally."

Lamb said she is most excited about the prospect of helping children with cancer. "I think that will be one of the greatest applications of this technology," Lamb said. "Male children diagnosed with cancer will be able to provide a biopsy specimen while they are young, and then they will be able to naturally conceive children when they are ready to do so as an adult."

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