• Credits

  • Section Writer: Dr. Om J Lakhani
  • Section Editor: Dr. Om J Lakhani

• Q. What is the best way for fertility preservation in men?

  • Cryopreservation of sperms is the best option

• Q. What are the indications for Semen Cryopreservation men?

  • 1. Young post-pubertal men desirous of future fertility who are planned for gonadotoxic chemotherapy, surgery, or radiotherapy
  • 2. Hypogonadotropic hypogonadal men on treatment with gonadotropins
  • 3. Young post-pubertal men desirous of future fertility planned for pituitary surgery
  • 4. Any other disease on treatment that can potentially impact fertility
  • 5. Men undergoing vasectomy
  • 6. In the case of transgender before undergoing surgery for gender congruence

• Q. How is semen collected in such cases?

  • Semen is generally collected using masturbation

• Q. What is done if no sperm are found on the ejaculated sample?

  • Sperms can be extracted with TESA and cryopreserved

• Q. What is done if the patient cannot ejaculate because of some local neurological issue?

  • Transrectal electroejaculation can be used for collecting the semen

• Q. What is a new experimental cryo technique in men?

  • Cryopreservation of testicular tissue
  • This is still experimental

• Q. What percentage of sperms survive Semen Cryopreservation?

  • 50% of the sperms

• Q. What are the three methods for preparing the sperms for Semen Cryopreservation?

  • 1. Swim-up
  • 2. Density gradient
  • 3. Culture medium

• Q. Which technique would you use for low sperm count?

  • Density gradient

• Q. What technique would you use for normal sperm count?

  • Swim-up technique

• Q. What are the methods for cryopreservation of the sample?

  • 1. Slow-freezing
  • 2. Rapid cooling- most commonly used
  • 3. Vitrification

• Q. What is the medium used for cryoprotection of the sperms?

  • Generally, glycerol is used for cryoprotection of the sperm

• Q. Can you describe the method for rapid cooling?

  • 1. Semen is mixed with cryoprotectant (Glycerol) in a dropwise manner
  • 2. The mixed sample is placed on a liquid nitrogen vapor for 10-30 minutes
  • 3. Then it is plunged into a liquid nitrogen storage container

• Q. What is the best ART technique to use when the sperms are in short supply while being stored?

  • Use Intracytoplasmic sperm injection (ICSI) since it would require only one sperm
  • Additionally, embryos can be made and preserved
  • This would be the best utilization of the sperms

• Q. How long can the sperms be stored?

  • There is no time frame per se
  • The longest storage has been for 24 years

• Q. How many cycles of freezing and thawing can be done?

  • Every cycle of freezing and thawing can cause sperm damage and DNA fragmentation
  • Three cycles of freezing and thawing is generally acceptable

• Q. Is there any increased risk of birth defects with the use of cryopreservation?

  • No.
  • There is no evidence to suggest increased birth defects

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