CRH Infertility Specialists

Sperm Cryopreservation & Storage

Semen is cryopreserved in men who are not able to produce a sample on the day of oocyte retrieval (due to performance anxiety), who are oligospermic, or azoospermic (post-MESA, PESA, or TESA). In men with azoospermia, epididymal or testicular samples are usually cryopreserved until the day of oocyte retrieval. On the day of oocyte retrieval, the semen sample(s) are thawed, the cryoprotectant is removed, and ICSI is performed.

Semen cryopreservation is an extremely important procedure for men (and even boys as young as 14) who want to preserve their fertility potential after cytotoxic treatment for cancer. The significance of notifying the patient of the potential risk of iatrogenic sterility as early as possible cannot be overemphasized. Physicians often are aware early during the diagnostic process that the patient will most likely need to receive potentially sterilizing cytotoxic therapy, although the exact diagnosis, stage, and treatment regimen have not yet been decided. This time should be used to initiate and complete the cryopreservation procedure.

The banking of at least three semen samples with at least a 48-hour period of abstinence between samples is recommended. This usually requires 5 to 8 days to complete. Additional samples (four) and longer abstinence periods (72 hours) to achieve higher total sperm counts may be considered. But fewer samples with shorter times are often obtained because of the need to initiate anticancer therapy quickly, and it is important to avoid possible increased genetic damage in sperm collected after the start of therapy.

Because of the low overall success rate with artificial insemination using banked semen in the past, it had been recommended that only samples with high sperm counts and motilities be stored. Currently, the success of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) make cryopreservation of all samples containing any live sperm appropriate. The facts that the cost of sperm banking is relatively low and that sperm may be stored fro years make this approach very cost effective.