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.
To make an
appointment, please call us TODAY at
615-321-8899.
