When could sperm cryopreservation be advisable?

- For couples undergoing assisted reproduction, and the man will not be at the hospital on the day of the intrauterine insemination or the puncture of follicles for IVF/ICSI procedure.

- Poor sperm parameters when the goal is to collect more sperm cells. When a severe deviation of the spermogram is detected, and a small amount of sperm cells with good motility is observed, it is possible to perform several procedures of cryopreservation. It is how to store different samples, and if it is necessary, they could be gathered, and the result is a more significant amount of sperm cells.

- When there is lack of sperm cells in the ejaculate (Azoospermia), but separate sperms are detected in the epididymis (the zone above the testicle where the semen mature) or the testicle. In this cases is required to perform the procedure PESA or TESE before the assisted reproduction. If this helps to collect sperm cells, they can be preserved to the moment of an ICSI procedure, which will include fertilization of her oocytes with the sperm cells collected before.

- For couples undergoing assisted reproduction, but when the partner has difficulties to produce semen, it is required the preliminary cryopreservation of sperm cells. They will be used in the day of the intrauterine insemination or the IVF/ICSI procedure if the partner cannot collect semen at the moment.

- Future chemotherapy or radiotherapy for the man.

- Future surgery because of oncology or other testicle diseases.

- For preserving the fertility of older man with genetic problems (e.g., Y chromosome microdeletion).

- Future vasectomy.

- By man’s own will.

What are the steps?

Step 1: Preparation tests including HIV, Syphilis, Hepatitis B and Hepatitis C, microbiology of ejaculate.

Step 2: Booking an appointment for the procedure. Sexual absence is required between 3 to 5 days before the procedure and 8 to 10 days for men with separate sperm cells with good motility. The patient should avoid alcohol and antibiotics two weeks before the cryopreservation. The semen must be collected in a specially equipped room in Dr. Shterev Hospital.

Step 3: Discussing with the patient the quality of his semen. In the day of collection of the ejaculate, the material undergoes examination (for 15-20 minutes) if it is possible to be cryopreserved. The next step is the freezing of a small part of the ejaculate and then its thaw it, and the aim is to assess the survival of the sperm cells after the procedure (cryo-tolerance test) than the semen is put in unique cryopreserving solutions certified for assisted reproduction and is kept in specially designed  containers with liquid nitrogen.

Step 4: Filing an Informed Consent for cryopreservation and storage of semen, including the desired keeping term.

Step 5: Cryopreservation and storage of the semen.

Step 6: After expiring the keeping term and if the patient did not indicate extension, the sperm cells should be destroyed. If the patient wants to extend this term, it is recommended to express this desire at least 1-2  weeks before the expiring date.

The innovations and progress of modern medicine give a chance to a lot more couples for conceiving and giving birth to a healthy baby. By virtue of the physicians, embryologists, and biologists every patient has his trusted team, with which help passes through the hard path to the big dream.