Learning About Cryopreservation for Male Fertility

Sperm cryopreservation is the process of freezing and storing sperm. It allows sperm to be saved for future family building. Sperm is mixed with a liquid called a cryoprotectant. It helps protect sperm cells from damage during freezing. Sperm is then stored in liquid nitrogen at very cold temperatures.

Frozen sperm can last for many years. It has been used safely more than 40 years after it was stored.

You may choose to freeze sperm for several reasons. One is to protect fertility before you have a treatment that could harm sperm. Or you may want to delay starting a family.

You might want to talk to your doctor about freezing sperm:

• Before chemotherapy or radiation. These cancer treatments can damage or destroy sperm.
• Before surgery that might affect how you make or release sperm.
• Before starting hormone therapy as part of gender-affirming care.
• When a health problem may lower fertility over time.

Sperm is usually collected by masturbation. This may be done in a private room at a clinic or at home.

The sample is checked for sperm count and quality. It's then mixed with a cryoprotectant and frozen. You may want to ask about collecting more than one sample. This may improve the chances of success in using the sperm later.

If sperm can't be collected through the release of semen, a doctor may use a procedure called testicular sperm extraction (TESE). Sperm is taken from the testicle in a minor surgery.

Collecting samples before any treatment begins may give the best results. Sperm quality can decrease after even one round of treatment.

Not all sperm survive the freezing and thawing process. Some cells may be damaged. If you have a serious illness, especially testicular cancer, you may already have lower sperm quality before freezing begins.

Or you may not have enough sperm to freeze. This affects roughly 11 out of 100 people with cancer who are referred for sperm banking.

There is usually a fee for collecting and testing a sample, plus yearly fees for storage. You may want to ask your clinic about these costs ahead of time.

For people who have not yet gone through puberty, an option called testicular tissue freezing is still being studied. Right now, it is only available through research programs at certain medical centers.

When you are ready to try to have children, the stored sperm is thawed and used in an assisted reproductive procedure.

Options may include:

• Intrauterine insemination (IUI). Sperm is placed directly into a partner’s uterus. On average, about four vials of frozen sperm are needed to achieve one pregnancy through IUI.
• In vitro fertilization (IVF). Sperm is used to fertilize an egg in a lab.
• Intracytoplasmic sperm injection (ICSI). A single sperm is injected into an egg. This is often used when sperm count is very low.

You will likely be asked to decide what to do if you can't use the sperm later. This might be because of death, divorce, or unpaid storage fees. Thinking about this early on may help you feel more prepared.