Endocrine Abstracts

The impact of DSD on fertility will depend on multiple factors. The key determinant of fertility potential will be gonadal development and function, and ultimately whether the individual has ovarian tissue with viable oocytes, or a testis capable of producing functional sperm. Whilst fertility preservation options are well established for many patient groups, such as those receiving treatment for cancer, fertility preservation options for those with DSD are less well established. Fertility preservation is primarily conducted for those who are due to receive gonadotoxic treatment that will damage an otherwise healthy ovary or testis. Egg/embryo collection and cryopreservation of sperm are well established options for fertility preservation for adults facing such treatment. For prepubertal individuals, gonadal tissue cryopreservation is the only viable option. Ovarian tissue cryopreservation and re-transplantation is an established method for fertility preservation and restoration in those facing sterilising treatments. However, for prepubertal males there are currently no proven clinical options to preserve and restore fertility. Current experimental approaches include removing testicular tissue from the patient prior to treatment for cryostorage and subsequent re-transplantation or in-vitro maturation of germ cells to generate sperm. In 2015, the first UK clinical research programme to develop approaches to preserve fertility in prepubertal and adolescent males facing gonadotoxic therapies was established in Edinburgh. This session will describe the current status of fertility preservation for young people with DSD, focusing on those with testicular tissue present. We will also discuss the clinical challenges associated with fertility preservation and restoration in those with DSD.