Which men can benefit from sperm cryopreservation?
• Adult men or teenagers undergoing treatment for cancer
Tremendous achievements in recent years in the early and accurate diagnosis of cancer have not only extended patient survival, but also focused thinking on life after treatment. Various cancer treatments (chemotherapy, radiation, surgery) can harm the testes (primary in sperm production); affecting not only spermatogenesis but also, the sexual function in the patient (decreased libido, premature ejaculation and erectile dysfunction). The cryopreservation of sperm before starting treatment preserves fertility and has a positive impact on the morale of the patient.
• Adult men or teenagers undergoing treatment, which can affect their reproductive capacity
Some treatments might affect a man’s fertility for quite a long time. The use of immunosuppressive drugs (e.g. for organ transplants or diseases such as rheumatoid arthritis) adversely affect the proper functioning of spermatogenesis. Ahead of such treatments, the patient should be advised of the possibility of a transient drop in sperm quality and, above all, the possibility of cryopreservation before starting treatment.
• Men who undergo surgery
Testicle (e.g. varicocele), prostate or bladder surgery for any reason can cause permanent or temporary changes in the reproductive function of the patient. Additionally, it can result in some degree of erectile dysfunction. In these cases, sperm cryopreservation is recommended before surgery, particularly if the patient is young and childless or going through an assisted reproduction process. This protects the patient from any possible complications for their reproductive health.
• Men exposed to chemicals
The professional and personal use of chemicals, especially pesticides, fertilisers and herbicides, either at production level or at application level (farmers, agronomists, and gardeners) is another aggravating factor in male fertility. There is a more urgent need for people who know that they are going to be exposed to a toxic agent, such as soldiers before an exercise, police officers, personnel at oil product and dye processing plants etc.
There is also clearly a potential for decreased reproductive capacity in men whose testicles are to higher temperatures daily due to their continuous sedentary posture (truck drivers, taxi drivers and clerical workers). In all these cases, sperm cryopreservation provides protection against conditions that might lead to some degree of difficulty in future attempts to have children.
• Men with a history of oligoasthenospermia
In recent decades, the tendency of people to have children at a later age has intensified the need to preserve their fertility. This need becomes even more pronounced in men with a history of low quality sperm. With cryopreservation, young men with known fertility problems can safeguard their reproductive capacity or when they decide to start a family. Of course, this applies to all men who do not want to start a family right away.
• The process of sperm cryopreservation
The process is relatively simple. It starts with the collection of sperm through masturbation. Sample checking and processing follows, and an initial analysis will determine sperm motility. After treatment with special cryoprotectant substances, the temperature of the sample is gradually reduced to -196ºC (the temperature at which all known biological functions of the cell cease) and it is stored in liquid nitrogen containers specially equipped for this purpose. In cases of azoospermia, the sperm is surgically extracted from the epididymis (PESA) or the testicle (TESE).
Sperm cryopreservation as a means of preserving fertility in men is, in most cases, easy, painless and inexpensive. It should therefore be offered as an option, especially in cases where people have not yet finished having children. Simple access to information can ensure that many men can become fathers, and offers them the opportunity to have their own biological children.