Cryopreservation of Sperm

This technique becomes particularly important in cases of preservation of male fertility before radiotherapy or chemotherapy which may lead to testicular failure or ejaculatory dysfunction. In fact, semen cryostorage seems to be the only proven method that may offer these couples a chance of having children in the future: cancer therapy could in fact lead to damage, resulting in subfertility or sterility due to gonad removal or permanent damage to germ cells caused by adjuvant therapy.

 In particular, the risk associated to therapy depends on several factors: the age of the patient at the time of treatment, the dose, site, and type of treatment .

Also some nonmalignant diseases, such as diabetes and autoimmune disorders, may lead to testicular damage. Cryopreservation is advisable also in these conditions.

 In azoospermic patients, who have undergone testicular sperm extraction or percutaneous epididymal sperm aspiration, sperm cryostorage is also used to avoid repeated biopsies or aspirations.

Furthermore, cryopreservation is routinely performed in patients who—having to start an assisted reproduction treatment—decide to preemptively freeze the semen sample to avoid inconveniences due to failed ejaculation often associated with “semen collection stress,” certain emotional states, or other commitments at the time of oocyte retrieval.

 Finally, male gamete freezing is largely recommended to preserve fertility in those subjects who—for one reason or another—are exposed to potentially toxic agents which may interfere with gametogenesis.

Oocyte cryopreservation

Oocyte cryopreservation can increase the chance of a future pregnancy for groups of women:

• those diagnosed with cancer who have not yet begun chemotherapy or radiotherapy;
• those undergoing treatment with assisted reproductive technologies who do not consider embryo freezing an option
• those who would like to preserve their future ability to have children, either because they do not yet have a partner, or for other personal or medical reasons.
• Additionally, women with a family history of early menopause have an interest in fertility preservation. With egg freezing, they will have a frozen store of eggs, in the likelihood that their eggs are depleted at an early age.

What is embryo cryopreservation?

Embryo cryopreservation is the process of freezing and storing the extra embryos. The embryos are then thawed and used at a later time. Embryo cryopreservation is a vital part of most IVF programs.

Why is embryo cryopreservation done?

• It can provide another chance to get pregnant if the IVF process fails the first time. The couple will not have to go through IVF again.
• If the man and woman have a baby, they can use the embryos later to have a second baby.
• The woman can save embryos before she begins treatments, such as for cancer, that might reduce or eliminate her chances of getting pregnant.
• The embryos could be saved and given to someone else in a donor program.
• The embryos could be saved and donated for research.

What is ovarian tissue freezing?

Ovarian tissue freezing is an experimental procedure for preserving fertility. During the procedure, one of your ovaries is removed. The tissue that contains your eggs is separated from the rest of the ovary, frozen, and stored for possible use in the future. If you’re no longer fertile after cancer treatment, using this tissue may help you have a biologic child.

Who is a candidate for ovarian tissue freezing?

• To be eligible for ovarian tissue freezing, you must meet the following criteria:
• You aren’t able to have your eggs or embryos frozen before treatment. Although egg or embryo freezing is generally the best option to preserve fertility, not everyone is able to have this done. Reasons for not being able to freeze eggs or embryos include:
• Being too young. Before puberty, girls don’t have mature eggs to be removed for freezing.
• Not being able to delay your cancer treatment for the 2 weeks it takes to have your eggs or embryos frozen.
• Having received recent chemotherapy.
• You will be getting a cancer treatment that will cause a significant loss of eggs and put you at a high risk of infertility (can’t have biological children) after treatment.
• You have enough eggs to have this option work for you if you need to use your ovarian tissue in the future. If you are older than 40 years of age, or if you have already lost most of your eggs from past cancer treatment, you won’t have enough eggs to have ovarian tissue freezing work for you.

Indications for testicular sperm freezing

 Fertility treatment

 Azoospermia

 Preserve sperm for later fertility treatment (ICSI)

 Avoid repeated testicular surgery

 Avoid problems in coordinating OPU and testicular surgery

 Ensure presence of sperm before ovarian stimulation

 Select patients for fertility treatment allocation

 Fertility preservation

 for boys and adults before starting gonadotoxic treatment