Sperm freezing and sperm banking
Sperm can be frozen for future use. Storing your sperm enables you to use them to make babies in the future using IVF procedure or intrauterine insemination IUI.
Storing sperm is the only established way to preserve male fertility. Studies have shown that sperm can be retrieved and stored from patients as young as 13 years old, and storing sperm for a long time should not change its ability to fertilize an egg. The sperm can be frozen as long as needed without losing any of its qualities. There is no limit to the time that sperm can be stored in a frozen state. The time of the sperm in storage does not influence the success rate.
Why do you have to freeze your sperm?
• You have cancer and facing a medical treatment for cancer that may affect your fertility, such as chemotherapy or radiotherapy.
• Before vasectomy in case you might change your mind later.
• Certain types of pelvic or testicular surgeries.
• You have a low sperm count or the quality of your sperm is getting worse.
• Diabetes, which may cause erectile difficulty.
• Anxiety on the day of egg retrieval when the sperm is needed (back up storage)
• You have difficulty producing a sperm sample on the day of fertility treatment or in case you’re travelling on the day of the egg retrieval when the sperm is needed to fertilize the eggs.
• You’re at risk of injury, or involved in high risk occupations which affect the sperm quantity and quality (drivers, cyclists, high temperature environment, and high radioactivity at work).
• If you're a male transitioning to a female, you might want to preserve your fertility and freeze the sperm before starting hormone therapy or a reconstructive surgery. Both treatments can lead to the partial or total loss of your fertility.
How many semen samples or vials have to be frozen?
Everyone’s situation is different. The sperm sample is divided into smaller amounts and transferred into multiple vials before freezing them. When you give a sperm sample to the laboratory, the embryologist might decide to split the sample into several vials depending on the sperm number and quality and purpose before freezing it. The number of vials stored depends on the total volume of the sample, and the number of mobile sperm in each milliliter. You might be asked to come to the clinic and give a sperm sample several times until you reach the needed total amount of vials to be frozen and stored.
Each time the sperm will be needed for a fertility procedure, a vial or 2 might be depending on the quality of the sperm.
Most men freeze between 2 - 5 sperm samples (2 – 5 vials) depending on many factors. Some choose to freeze much more vials.
The number of sperm specimens cryopreserved will differ for each patient and depends on:
• The patient's age
• The number of children he already has and the number of kids he might want in the future.
• Semen quality, partner's fertility status, and overall health.
• The time interval before surgery, chemotherapy or radiation therapy.
• The purpose of freezing the sperm (short term freezing for fertility procedures in case the partner is travelling or cannot come to give the sperm sample on a required date or for long term freezing).
The number of vials stored depends on the total volume of the sample, and the number of mobile sperm in each milliliter.
We usually freeze 3 – 5 vials of sperm for short term use such as in IVF procedures for the international patients when the male partner cannot attend the clinic to give his sperm on a required day.
We usually freeze at least 12 vials of sperm for long term use in case the sperm count or motility are decreasing gradually and might disappear and in cases before starting cancer therapy.
How the semen for freezing is obtained?
Semen for cryopreservation is obtained by masturbation either in the IVF Lab or, have to be brought within 1 hour of being produced.
We recommend abstaining from intercourse and ejaculation for at least two days but not longer than five days before the first sample, and for about two days interval between the samples in case 1 sample of sperm is not enough.
Once in the laboratory, an analysis of the quantity and quality of sperm is made on a small part of the sample. The remaining part of the sperm sample is divided into smaller amounts and transferred into multiple vials for freezing.
The highest number of sperm will be found in the semen if at least 48 hours is allowed between ejaculates. If time permits, we generally recommend that at least 3 separate ejaculates be banked. We take in consideration the time interval before surgery, chemotherapy or radiation therapy. If possible, it is best to freeze the sperm specimens before chemotherapy begins because there are concerns that chemotherapy drugs may have unknown effects on the sperm and the offspring.
More vials of frozen sperm will increase the chance of a successful pregnancy, as well as the ability to attempt other pregnancies.
Newer assisted reproductive techniques, such as Intra-Cytoplasmic Sperm Injection (ICSI) make fertilization possible with only very few sperm. Similar to traditional IVF, eggs are retrieved from the female's ovaries after having 9 -12 days of injections to stimulate the ovaries; a single motile sperm is injected directly into each egg, greatly increasing the chances of successful fertilization and allowing the use of very few sperm. The fertilized egg becomes an embryo which is transferred into the uterus 2 – 5 days later and then developing a pregnancy which is carried in the woman's uterus until birth.
Control on what happens to your sperm?
When you first freeze your sperm, the clinic will ask you to fill out consent forms for your sperm to be stored.
The consent forms allow you to specify:
• What will happen to your sperm in case you become unable to make decisions for yourself or die?
• How long you want to store your sperm?
• Whether your partner (if you have one) can use the sperm later to create a family.
• You can change or withdraw your consent at any time, either before the fertility treatment or before the sperm is used or after using a part of it.
• You must let the clinic know if you change your address or phone number. This is so they can contact you when the storage period is coming to an end and to ask you if you would like to make a prolongation of sperm freezing or not. If they cannot contact you when the storage period ends, they will take your sperm out of storage and allow them to perish.
How safe is it using frozen sperm?
It’s very safe – there aren’t any risks to patients or children from using frozen sperm.
Research has shown no difference in the rates of abnormalities or birth defects among children conceived with fresh or frozen sperm.
How successful is using sperm freezing?
Research proved that frozen sperm and fresh sperm have the same success rates.
How long can your frozen sperm be stored?
You can store your sperm as long as you wish. There are no time limits upon sperm freezing.
Time and freezing doesn’t change or affect the sperm quality.
You must let the clinic know if you change address. This is important because if the clinic can’t reach you at the end of your agreed storage term, they may take your sperm out of storage and allow them to perish.
It’s vital that you stay in touch with your clinic to prevent your sperm from being discarded if your storage term finishes.
What happens when you want to use your frozen sperm?
When you need your frozen sperm for a fertility treatment such as In Vitro Fertilization (IVF), Intra-cytoplasmic Sperm Injection (ICSI) or Intra-uterine Insemination (IUI), a vial or 2 vials of your frozen sperm will be thawed, and they’ll be used in exactly the same way as fresh sperm. Each time the frozen sperm is needed for a fertility treatment a vial or more are thawed depending on the sperm count and sperm quality.
If you don’t use your sperm or if you have some more sperm left in the lab?
If you have frozen sperm that you don’t want to use, you sign a consent allowing the IVF lab to discard your semen samples by removing them out of storage and allowing them to perish.