Adult somatic cells to the rescue: nuclear reprogramming and the dispensability of gonadal germ cells.

With advances in cancer therapies, survival rates in prepubescent patients have steadily increased. However, a number of these surviving patients have been rendered sterile owing to their rigorous oncologic treatment regimens. In addition to cancer treatments, men and women, who are genetically fertile, can become infertile owing to immune suppression treatments, exposure to environmental and industrial toxicants, and injury. Notwithstanding the great emotional burden from an inability to conceive a child with their partner, the financial burdens for testing and treatment are high, and successful treatment of these patients' sterility is rare. Recent advances in pluripotent stem cell differentiation and the generation of patient-specific, induced pluripotent stem cells indicate that stem cell replacement therapies or in vitro differentiation followed by IVF may be on the horizon. Here we discuss these recent advances, their relevance to treating male-factor and female-factor infertility, and what experimental procedures must be carried out in animal models before these exciting new treatments can be used in a clinical setting. The goal of this research is to generate functional gametes from no greater starting material than a mere skin biopsy.