To comprehensively reviewed the literature on various methodologies in preserving fertility in the prepubertal male.

A systematic review was conducted from 2005 to 2025 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was performed on PUBMED to identify studies investigating the various methodologies in preserving fertility in the pre-pubertal male and the clinical impact these approaches have.

Of the 244 articles reviewed, 125 articles met inclusion criteria and were analyzed for eligibility. For prepubertal males not yet making sperm, fertility preservation options are predominantly experimental in nature at this time. Tissue cryopreservation is the only available preservation method, while spermatogonial stem cell transplantation, testicular tissue grafting, in vitro gametogenesis from pluripotent stem cells (PSC), and stem cell cultures are the most promising fertility restoration methods actively being studied.

As these methodologies gain momentum, increased work evaluating patient safety, parent acceptability, and physician methodologies for establishing fertility preservation studies has also been of interest.