Sperm freezing is offered to men undergoing testicular surgery, chemo or radiation therapy to preserve their future fertility. Additional indications include obtaining sperm from the testicle (TESE – Testicular sperm extraction) or from the storage area called epididymis (MESA – Microsurgical epididymal sperm extraction) for treatment of infertility. Sperm can also be frozen in men who are planning on undergoing vasectomy, with a history of vasectomy or who recently had vasectomy reversal.
Chemotherapy and radiation treatment can damage the testicles and reduce or completely stop sperm production. The damage depends on the type of the chemotherapeutic agent, exposure time and the dose of radiation therapy. It is recommended to freeze sperm before undergoing chemo or radiation therapy and all patients should be counseled prior to such exposure.
When sperm is obtained through testicular biopsy such as TESE or MESA, the number of sperm is typically much less than the ejaculate. Sperm can be frozen in aliquots and used one at a time if additional infertility treatment is necessary such as in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI). If the sperm is frozen from the ejaculate, more sperm is present prior to freezing and following thawing. When pregnancy is desired, intrauterine insemination (IUI) or IVF can be done. The longest time period that the sperm was frozen that resulted in a healthy pregnancy was reported to be 28 years. Success rates using frozen-thawed sperm are comparable to fresh collected sperm in men with normal semen parameters undergoing IVF.