Fertility Preservation in Men

What is Sperm Cryopreservation

Sperm Cryopreservation is a technique in which the semen is preserved in patients undergoing cancer treatment or infertility treatment.

When is Sperm Cryopreservation indicated?

1. Semen freezing process is a boon for people with cancer such as testicular or prostate cancer.
2. People who have difficulty in giving the sample on day of egg collection.
3. People with retrograde ejaculation
4. People with hazardous jobs
5. People with any surgeries planned
6. Men not available at time of egg collection

What are the pre-requisites of Sperm Cryopresrvation?

The semen sample is collected and checked under the microscope before the storage, for concentration and motility and then stored in small vials for future use. Proper consent is taken from both partners or guardian in case of minor before the sperm freezing procedure. All viral markers should be negative.

What is the process of Sperm Freezing?

1. Sperm Production: the male partner is advised to have an abstinence of 1-3 days before the sperm collection. The method could be masturbation, electro-ejaculation, or surgical sperm retrieval in cases of poor sperm parameters.
2. The sample is collected in a sterile, wide mouthed, container.
3. All the viral markers are checked negative before the sperm freezing like, HIV, Hepatitis B, Hepatitis C, and Syphilis
4. The sperm sample Is then allowed to liquefy at room temperature and homogenized properly.
5. The sperm sample is then assessed for the concentration, motility and morphology of the sperm. Pre freeze sperm parameters will be the accurate predictor of post thaw sample.
6. Depending on the sample , the sperm may be frozen raw/prepared.
7. The freezing of sperm generally involves slow freezing method in which the sperm sample is frozen at various temperature ranging from 2-8 degrees to then -20 degrees (vapor phase) and then plunging into the liquid nitrogen over a period of 30-60 minutes.
8. The sperm thawing process is taking out the semen vials and keeping it in room temperature for about 10 min and at 37 degrees till it liquefies properly.
9. The sample is then washed to remove all the cryoprotectants before using for any procedure.

The main cryoprotectant used is glycerol, or DMSO ( di-methyl sulfoxide) which will prevent the formation of ice crystals and will DNA integrity and function of the sperm cells after thawing.

During the freezing and thawing process sperm may undergo osmotic stress, oxidative stress, toxicity from cryoprotectants, reduction in number of normally function sperms etc, and hence to control such events the most commonly used cryoprotectant is glycerol with egg yolk which reduces osmotic stress within the spermatozoa.

How long can the Sperm be frozen?

The sperm can be frozen for a minimum of 10 years without any major changes in the sperm parameters if cryopreserved properly, though multiple times re-freezing and thawing may lead to poor sperm retrieval rate.

How frequently do you need to renew Sperm Freezing?

It can be renewed every 3-6 monthly.