Fertility Preservation for Men
Men have long been able to preserve their fertility by freezing their sperm. Tour de France champion Lance Armstrong's three children were conceived with sperm he banked before chemotherapy.
Fertility Preservation for men may be done for several reasons:
- Cancer patients before undergoing chemotherapy or radiation. Cancer treatment adversely affects sperm quality and can lead to infertility. We strongly encourage patients to freeze semen, preferably before initiation of cancer treatment to preserve fertility. Patients may need to undergo radiation, chemotherapy, or surgery as part of medical management. Each of these treatments has deleterious effects on sperm production and can contribute to infertility. Certain types of cancer may also affect sperm quality even prior to the beginning of treatment. Recent studies have shown that semen from patients with many cancer types including testicular, seminoma, prostate, lymphoma, leukemia, and Hodgkin's can be successfully frozen, even when sperm counts are low. Due to potential genetic damage caused by chemotherapy or radiation, it is recommended that sperm be frozen before cancer treatment is initiated.
- Patients who are electing to have a vasectomy but wish to have sperm stored.
- Patients who are expecting to be unavailable at the time of insemination and wish to store sperm for their partner’s use.
Men with very low sperm counts or poor quality sperm may still successfully freeze sperm when used with assisted reproductive technologies such as IVF and ICSI.If there is complete absence of sperm there is still the possibility of cryopreserving sperm in some cases. As long as at least one testis has areas of sperm production, sperm can be retrieved surgically from the epididymis or the testicular tissue and frozen for future use with ICSI.
Technologies for Fertility Preservation in men include:
- Semen freezing: Semen is collected, frozen, and stored. Semen freezing is a well established procedure. The sperm can be stored for years and used later for intrauterine insemination (IUI) or Intracytoplasmic Sperm Injection (ICSI). For men undergoing chemotherapy, radiation or surgical castration, we recommend collection of multiple samples prior to the initiation of therapy. The semen sample is tested for quality and stored in a sperm bank for future use.
- Percutaneous sperm aspiration (PESA): Sperm are obtained through a needle aspiration of the epididymis (the sperm storage area outside the testis), frozen and stored.
- Testicular sperm extraction: Testicular tissue is obtained through an open biopsy or with a biopsy gun. The sperm cells and cells that produce the sperm are frozen and stored.