Programs and Services

Preserving Fertility for Men

Sperm Freezing (Cryopreservation) for Men Receiving Cancer Treatment

Upon receiving a diagnosis of cancer, a man’s immediate concern is receiving successful treatment. Fortunately, early detection and improved treatments have dramatically increased the survival rates for men with testicular cancer, Hodgkin’s disease, leukemia, lymphoma and other cancers.

Unfortunately, various cancer treatments — chemotherapy, radiation and surgery — may impair a man’s fertility. This is a concern when a man has not yet started or completed his family. While having children may be far from a man’s mind when he begins cancer treatment, it may be an important issue in the future.

Cancer treatment can reduce the quality of sperm or completely halt the production of sperm. This will vary with each man, depending on the disease progression, the type of treatment and the location of the cancer. For some men, sperm production may resume within a few years of treatment. For others, fertility may be lost forever. Cancer treatment also may affect a man’s ability to ejaculate.

Today, cancer treatment does not have to end a man’s ability to have children. Through sperm-preserving techniques, fatherhood can be possible — in the near future or many years from now. (Sperm preservation techniques may be covered by health insurance. Contact your insurance company for questions about coverage.)

Sperm Freezing

Before beginning cancer treatment, sperm can be collected and frozen (cryopreserved). This is a safe and effective way to preserve sperm.

Depending on when treatment begins, a man may be able to provide multiple samples of sperm for freezing. Even if only one sperm sample can be provided, a man should consider doing so. Advances in reproductive medicine techniques make it possible for successful fertilization to be achieved using a single sperm cell.

The sperm will be tested to ensure they are healthy before they are frozen. The frozen sperm can be stored indefinitely at Froedtert & the Medical College of Wisconsin. Typically, about half of the sperm survive the freezing process.

The sperm can be thawed and used with insemination techniques:

If the quantity of ejaculated sperm is sufficient, it can be used for intrauterine insemination, a procedure in which the sperm are deposited into the uterus through a thin tube in the hope of achieving fertilization and pregnancy.
If the sperm have been surgically retrieved from the testis or epididymis, there will not be enough highly mobile sperm for intrauterine insemination. In this case, in vitro fertilization is used to attempt fertilization.

While it may be possible to retrieve sperm after cancer treatment, preserving sperm before treatment should be considered for many reasons. Depending on the treatment, it may take three to five years or longer for the man to produce sperm again. In some cases, there may be no sperm production at all, or the sperm quality may be greatly reduced.

Cost is another consideration. The least costly approach is to provide sperm through ejaculation for freezing (there is an annual fee for storing the sperm). The cost to retrieve sperm surgically is somewhat higher; if necessary, however, it is possible to retrieve sperm surgically before or after surgery.

Testicular Tissue Freezing

For various reasons, a man may be unable to produce sperm. Nerve damage, for example, may prevent a man from being able to ejaculate. In another situation, a man may not have any sperm in his ejaculate. This may be caused by a medical condition or cancer treatment. In both cases, however, sperm may still exist in the testes.

Testicular tissue banking involves surgically removing a small piece of the testicular tissue and freezing it. The tissue is removed during an outpatient procedure. The tissue is then cut into several pieces and then frozen.

At a future time, the tissue can be thawed and the sperm retrieved. The sperm can then be used to fertilize eggs by intracytoplasmic sperm injection (ICSI), an in vitro fertilization procedure in which a single sperm is injected directly into an egg to attempt fertilization. Each piece of testicular tissue can provide enough sperm for an in vitro fertilization cycle.

Author: Marla Fraunfelder