Male Fertility + Health

Sperm Freezing 101

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You may have heard quite a bit about egg freezing, through Progyny or elsewhere, but what about sperm freezing? What is it, why is it done, and who should consider it?

Much of the reason we hear more about egg freezing than sperm freezing is truly biological. Females are born with all the eggs they’ll ever have, meaning the quantity and quality of eggs will diminish throughout their lifetime. Men, on the other hand, can produce new sperm every 3 months. While male fertility does somewhat diminish with age, there is less of a drastic decline. The urgency to preserve fertility for most is less urgent, knowing they won’t run out.

However, it is not a one-size-fits-all mold – seldom things in fertility are – and there are, in fact, many reasons a person will be guided to or decide to choose to freeze their sperm.

To learn more, I spoke with Christopher Antonelli, Director of Laboratory Operations at Generate Life Sciences. Generate Life Sciences owns and operates California Cryobank – a nationwide group of facilities dedicated to cryopreservation (the process of freezing tissue for future use), so Christopher knows a thing or two about sperm freezing.

What is sperm freezing?

Cryopreservation of sperm is the process of preserving sperm, in a cryogenic state, so that it can be used at a later date. Cryopreservation of sperm can be used to have biological children, or to donate for someone else’s attempt at conceiving.

How common is sperm freezing?

While we don’t have an exact number, California Cryobank reports between 2,300 – 2,500 men storing sperm on-site annually at their clinics. As accessiblity to cryopreservation increases, as well as education, sperm cryopreservation is increasing.

Who is recommended to freeze their sperm and why?

There are many reasons why it is medically necessary to store sperm, mainly to preserve the ability to have genetically related offspring in the future. Alike, there are many reasons to store that are personal choice or (convenience) but may not be medically necessary. Below we review some of the common circumstances or reasons why patients decide freezing their sperm is right for them.

  • Prior to cancer-related therapies — Some treatment of lymphomas, testicular, and other types of cancer can affect future fertility. Radiation therapy may cause dose-related suppression of spermatogenesis – the body’s sperm production. Chemotherapy is comprised of alkylating agents (substances that alter DNA molecules in the hope of stopping cancer cells from multiplying) which do the most damage to spermatogenesis. The risk is increased with two or more alkylating agents, high doses, and chemotherapy combined with radiation.
  • Prior to testicular or prostate surgery — Sterility may occur following testicular surgery or prostatectomy. Surgeries, particularly testicular, prostate, or bladder surgeries, may cause ejaculation complications that can interfere with the ability to achieve a pregnancy though sex.
  • Prior to a vasectomy — The option to store sperm prior to a vasectomy can preserve fertility potential and prevent the need for reversal surgeries if circumstances change during one’s lifetime. In addition, vasectomy reversal surgery is not always successful.
  • Prior to gender-affirming therapies – MTF (Male to Female) trans individuals may choose to have hormone therapy or a surgical procedure as part of their gender-affirming treatment. The effects of hormone therapy on MTF patients is detrimental. To positively impact fertility at this juncture would require a person to go off therapy in the future to collect sperm. Many times, this is not an option for these individuals. Additionally, gender reassignment surgeries have a permanent effect on one’s fertility. For MTF trans patients, banking specimens before hormone treatment and/or surgical options is an option to preserve fertility for future use.
  • Prior to an upcoming fertility procedure — Storing sperm prior to assisted reproductive procedures ensures its availability at the critical time of the procedure. Many times, patients struggling to conceive need immediate access to sperm. Heterosexual couples may attempt to collect a specimen the day and sometimes the hour that the fertility procedure will take place. Busy schedules for both tissue providers complicate this delicate timeline. Conversely, cryopreserved samples can be used and will not impede the fertility cycle due to timing in any way.
  • Prior to traveling to a high-risk area – Infectious diseases such as Ebola and Zika can cause fertility issues and may have a devastating impact on fetal development. Men traveling to areas of the world with a greater Ebola or Zika threat sometimes choose to store their sperm before departing as a safety measure for future conception.
  • Diagnosed with a medical condition that is beginning to affect your ability to ejaculate – Many medical conditions can impact a male’s ability to ejaculate effectively. Conditions such as multiple sclerosis and diabetes can negatively impact one’s ability to ejaculate. This can severely lower chances of conception. Following a diagnosis, some may opt to freeze sperm before the condition worsens.
  • Sperm freezing is common with men diagnosed with certain cancers – which cancers are most applicable? All cancers, as it is the treatments that most often are the cause of sterility or infertility. Some treatment of lymphomas, testicular, and other types of cancer can frequently render male patients infertile.
  • For high-risk occupational exposures — Recent studies have shown that on-the-job exposure to hazardous materials can have profound health consequences, including male infertility. High-risk occupational exposures may include, but are not limited to:
    • Men exposed to environmental toxins such as chemicals, herbicides, pesticides, lead, radiation, and an increasing list of agents used in everyday life.
    • Professional athletes who risk testicular injury.
    • Men in the military or first responder professionals.
  • For oligospermia (low sperm count) patients — If oligospermia has been diagnosed, and the patient decides to bank his sperm; the option of combining several different ejaculates that were cryopreserved may increase the chance of conception.
  • Fertility preservation – Some choose to simply freeze and bank sperm as peace of mind to ensure that their future family building is secure, especially those who are single.

How many oncofertility patients freeze sperm vs. non-oncofertility patients?

50% – 60% of the patients at California Cyrobank are banking due to cancer diagnosis. The other 40-50% are pre-hormone replacement therapy, pre-vasectomy, age or future use concerns, and to aid with an upcoming assisted reproductive technology (ART) procedure.

What is the sperm freezing process like? What are the steps a patient goes through during this process?

The sperm storage process generally involves 1-3 visits to the Cryobank or fertility clinic depending on the patient’s needs.

At California Cryobank, for instance, the patient will meet with a Fertility Preservation Coordinator to complete required documentation. Once complete, the patient will then provide his semen specimen. A private room equipped with streaming TV’s is provided to make the experience as easy as possible. If the patient is experiencing health issues and cannot physically report to a Cryobank location, offsite collection may be allowed. This is especially beneficial for immune-compromised individuals who may have just begun or will begin treatment on their health issue.

Additionally, there are certain infectious disease screening tests that are required. This requirement may vary due to the reason for storage. The best option will be presented for the patient’s specific reason for storing. However, generally, a blood draw and urine sample collection are completed at the Cryobank or fertility clinic during your appointment. The samples are then sent to an outside laboratory for testing. Having infectious disease completed at the time a patient cryopreserves their samples may increase the amount of options they have when they go to use the samples. For example, to use a surrogate carrier, will require additional testing to be completed. Having the initial disease testing complete will help illuminate the patient’s options for future use.

Results from cryopreserved samples are typically available the next day. The patient is encouraged to share their results with their MD. Their MD can help facilitate a discussion around the number of ejaculates needed to cryopreserve needed to suit the patient’s future needs. For family building and planning purposes the number of future visits and deposits will depend on the individual patient’s needs and availability. If you are a Progyny member and would like to get started, contact your dedicated Patient Care Advocate.

Where is sperm stored?

Vials are stored in liquid nitrogen storage tanks. Within the tanks, there are individual racks, with numbered slots. Each vial goes into a unique slot, the identity of which is recorded and then saved in multiple locations. This ensures all inventory can be easily and accurately found. Each tank has its own continuous temperature monitoring system. Staff is on call 24/7, 365 days a year. Each tank is monitored remotely as well as in-person to ensure redundant systems to avoid any type of malfunction or failure.

How long can sperm be kept in storage?

Theoretically, indefinitely! Once sperm has been frozen and stored in liquid nitrogen, there are no known upper limits on how long it can be preserved. Successful pregnancies have been reported from specimens frozen up to 28 years!

Why would Trans Women choose to freeze sperm?

Many reasons, however, to simply preserve the possibility of having future genetic offspring is the most common. Additionally, an individual storing prior to Hormone Replacement Therapy (HRT) or surgical options, will be offered the ability to be screened so they can use their specimens with a gestational carrier should they so choose. Being properly screened from the start, to use specimens with a gestational carrier, is essential or maximize the number of future possibilities for use that this population of individuals will have.

Do most fertility clinics offer sperm freezing?

It has become more common for clinics to offer sperm freezing. If they do not offer sperm freezing, they should be able to refer you to a clinic they partner or work with to meet their patient’s needs.

Why is it difficult for single men to be seen at fertility clinics for sperm freezing only?

Some fertility clinics’ primary focus is to help their patients with assisted reproductive technology (ART) to achieve pregnancy.  Many times, these clinics do not have the physical space, staff, and/or cryogenic facilities to offer sperm freezing and long-term storage.

Are there companies that focus on sperm freezing? If so, what are they and how do they work?

Yes, there are! Dedicated sperm banks such as California Cryobank are focused on patient-centric reproductive services. When a patient begins their journey at a sperm bank, they should expect to be met with expansive education, guidance, and expertise.

The process of sperm freezing will begin with a consultation and evaluation. The patient should then expect an outline and explanation of the process step by step, including timetables customized to the patient’s needs and purpose for storing. All physicians, lab technicians, and genetic counselors, like those at California Cryobank, should leave no question unanswered and make sure patients feel supported and empowered as they move through their sperm freezing journey.

What is the typical cost of sperm freezing?

This depends on your needs, such as how many specimens you wish to store, which may be based on how many children you wish to have and semen quality. Consultation, initial semen freezing, and infectious disease testing is less than $600. Then individuals may select the initial term of storage based on individual needs.  If you are a Progyny member, reach out to your dedicated PCA to learn more about what’s covered under your Progyny benefit.

Does health insurance typically cover sperm freezing?

Fertility preservation benefits vary by insurance providers. In alliance with the LIVESTRONG Foundation, California Cryobank is proud to offer the LIVESTRONG Fertility Program which provides financial assistance on sperm banking and storage for cancer patients that qualify.

Many employers who administer the Progyny benefit also cover sperm freezing – call your Progyny PCA to see if yours does!

 

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