Memoir of Fertility Preservation

Fertility preservation has been practiced for at least 50 years using semen banking, pelvic surgery, and radiation shields, but in the past 20 years it has emerged as a rapidly growing subspecialty of reproductive medicine. A dramatic rise in survivorship of young cancer patients and the widespread postponement of family building to the later years of the female reproductive lifespan have been major driving forces. Throughout the history of fertility preservation, low temperature banking has played a pivotal role, first for gametes and later for embryos and immature germ cells, while ovarian transplantation recently began to contribute and spermatogonial stem cell transfer holds future promise for men and prepubertal boys. But there are significant risks with some diseases from reimplanting residual disease, which hopefully can be eliminated by new methods for purging the tissue and germ cell culture. Since all technologies are interim, cryopreservation as a mainstay in this field will likely be swept aside eventually by a stream of progress aimed at managing fertility preservation in vivo.