Semen freezing is a procedure used to preserve male fertility. Sperm freezing or Semen Cryopreservation is a way for men to conserve their sperm and collect it in a bank so that it may be utilized in the future. Men can choose to freeze their sperm before getting any medical treatments which may damage sperm quality, like several types of cancer treatment like chemotherapy and radiation.
Indications for sperm freezing
Sperm freezing helps patients who cannot become parents otherwise and is recommended in the following cases:
Men who suffer from cancer who are going to be treated with chemotherapy and radiotherapy will have to preserve their fertility before undertaking these treatments, in case their wish is to be a father. There is a chance the sperm alteration could be reverted once they have overcome the disease else these frozen samples could be used for infertility treatment if the reproductive potential is affected.
Some patients decide to have a vasectomy as a contraceptive measure because they do not want to have more children, but choose to save a cryopreserved semen sample as a precaution. So they still have the chance to become parents.
Freezing a few sperm samples is recommended in patients with decreased sperm quality before starting a fertility treatment. The main goal is to make sure that there will be sperm available to fertilize the eggs collected on the egg retrieval day
Sperm cryopreservation allows men to be more comfortable who experience difficulties when trying to ejaculate on the Intra-Uterine Insemination (IUI) or IVF(In Vitro Fertilization) day, mainly it would be helpful for patients with ejaculation problems due to a mental block, or those who cannot visit the clinic because their place of residence is far from it (especially in egg donation cycles).The valuable samples are optimized so it allows the samples to be dosed and used little by little, on the idea of need mainly those obtained via testicular biopsy or epididymal sperm aspiration, sperm washing in HIV- positive patients, or cancer patients.
Clinics must conduct a series of tests to see that the semen samples are healthy to make sure that the samples are not affected by HIV. The screening process must be carried out months after the donation is completed therefore it becomes necessary that the collected samples have to be frozen beforehand.
Transgender women can cryopreserve their sample before undergoing sex reassignment surgery so as to use it later in a gestational surrogacy process. Lesbian couples could also use it to undergo fertility treatment.
Apart from being offered to cancer patients before therapy, other indications for sperm cryopreservation are the preservation of donor sperm in the absence of viable sperm from the male partner, traveling husbands, like those serving in the military, or as fertility preservation before radical surgery, pre-vasectomy, or for the other medical reasons.
HOW IS SPERM FROZEN?
Once the semen sample is collected it is placed on a warming block that’s 37°C so that the sperm can turn into liquid. Then the experts will combine the semen sample in a 1:1 ratio with a freezing medium. This enables the sperm to sustain the freezing and storage method.
Process of sperm freezing
Sperm freezing is a simple technique that can be done in the IVF lab.To guarantee that the safety of the samples isn’t compromised when handling them within the lab, the patient must provide updated serologies before the sample is frozen.In the Cryopreservation technique, the cells are stored with the initiation of metabolic arrest for a prolonged period of time with the cells retaining their viability and fertilizing potential (for gametes). Cryopreservation of spermatozoa is a well-established technique, and the normally used cryopreservation method is the slow-freezing method. Slow-freezing is done using a cryoprotectant using a slow decrease in temperature (low cooling rate). However, after thawing, this method shows a decrease in the quality of sperm parameters, which is essentially attributed to oxidative stress-induced changes and intracellular ice crystal formation. The sample is distributed in cryotubes after adding cryoprotectants, which lower their temperature slowly until they are ready to be frozen in liquid nitrogen, at a temperature of -196 °C. freezing and thawing steps there are chances of the sperms getting damaged. Sperm quality is not affected during the storage process. When handling valuable samples of cancer patients, testicular biopsy, sperm washing in HIV-positive patients they can be frozen in small samples so as to optimize their use each time.
Sperm vitrification is a method that allows for ultrarapid freezing, which reduces the duration of the procedure.This method has been widely used for the cryopreservation of eggs and embryos since they are more sensitive to freezing procedures than sperm because of the fact that eggs and embryos contain more amount of water inside. However, there is no need for the vitrification procedure as the sperm are barely altered by the freezing process.
What to expect after the semen freezing
The most important factor when a man is about to freeze his semen is sperm quality, namely the sperm count and sperm morphology age is not a determining factor to decide whether freezing is good or bad. If sperm quality is bad, the severity of sperm disorders will be higher, the results may be affected in a technique that requires a greater sperm count (e.g. IUI), Even if some of these parameters are altered, some studies have proven that the results of fertility treatments where ICSI with donor sperm is used are not affected.
Some of the sperm parameters can be altered after the thawing process (such as the number of live sperm or sperm motility) in high-quality samples also although this technique does not affect the success rates of fertility treatments.
How are Frozen Sperm used in Fertility Treatments?
The sample is frozen after the sperm is analyzed. The frozen sperm is stored in a sperm bank to be used later in Assisted Reproductive Technology (ART) cycles. Sperm cryopreservation does not affect sperm quality and can be stored for an indefinite period of time. Sperm freezing enables the sperm to be used in the future for fertility treatments like:
• Intrauterine Insemination (IUI)
• In Vitro Fertilization (IVF)