A first for the UK

Surgeons have performed the first testicular tissue transplant on a teenager in the UK. A team of NHS medics in Edinburgh transplanted previously frozen testicular tissue back into the patient's body, hoping it will enable him to produce sperm. The operation is the first of its kind in the UK, and only the second reported to have taken place worldwide.

It was carried out by medics at NHS Lothian, backed by funding from Children with Cancer UK, and follows a decade of research by the University of Edinburgh. Doctors expect to know within months whether the procedure, which took place in August, has enabled the 19-year-old to produce viable sperm.

Why the tissue was frozen

The 19-year-old had his tissue removed and frozen three years ago, before undergoing treatment for a serious blood disorder. Three years after his chemotherapy, tests showed he had no sperm in his semen.

Chemotherapy can permanently damage the cells needed to produce sperm, leaving children who undergo it at risk of infertility. Freezing semen is an established fertility preservation method for older teenagers and adult men, but for pre-pubescent boys this is not an option. The tissue taken for transplant contains spermatogonial stem cells, which are responsible for producing sperm from puberty onwards.

• •Chemotherapy can permanently damage the sperm-producing cells
• •Pre-pubescent boys cannot freeze semen, so tissue freezing fills a gap in fertility preservation
• •The stored tissue holds the stem cells that generate sperm from puberty onwards

What the patient said

The patient, a student who asked to remain anonymous, said he was "incredibly grateful" to the medical team behind the pioneering procedure. "Fertility is something I've struggled with personally for a long time," he said. He said he had always wanted children of his own but had found himself slowly starting to accept that it might never be possible.

He also said he hopes that being part of the research means that, in the future, other young people in the same position can have that hope.

The team and the research behind it

Rod Mitchell, professor of developmental endocrinology at Edinburgh's Institute for Regeneration and Repair and consultant paediatric endocrinologist at NHS Lothian, said: "This is a big step towards helping boys facing treatments that damage their fertility to have children of their own."

He said the research programme to freeze and store pieces of testicle from boys before they start chemotherapy began ten years ago. According to Mitchell, young men who had tissue stored are beginning to return to explore their fertility options, and the study offers real hope for future fertility in boys facing cancer treatment.

Tracey Gillies, medical director at NHS Lothian, described the operation as a "landmark procedure" marking an important step for children whose fertility may be affected by treatment. "We are grateful to the patient and his family for helping advance research that could transform care for others in the future," she said.

Globally, more than 1,200 patients in the UK and 3,100 worldwide had had testicular tissue stored for potential future use, according to the University of Edinburgh. In May, a man whose tissue was frozen before childhood chemotherapy and retransplanted 16 years later was reported to have produced sperm. Doctors should know in a matter of months whether the August procedure has worked.