Semen cryopreservation is a way of helping men safeguard their fertility by storing their sperm at extremely low temperatures. The first successful use of sperm that had been stored at -196◦C in liquid nitrogen was in the 1950s, and since then, sperm storage has become a routine, widely practised procedure. Men are offered the opportunity to store their sperm samples for a variety of different reasons, and the doctor who referred you to our clinic will be able to give you more specific information about why it has been recommended for you.
For some men, sperm storage will be short-term, with a view to using the samples infertility treatment soon after freezing them. Other men will require longer-term sperm storage because they are undergoing treatments that could affect their sperm production, or the DNA in their sperm eg chemotherapy and/or radiotherapy. It is not always possible to predict what the effects of these treatments will be, or if they will affect fertility permanently. Men who freeze their sperm samples before treatments such as chemotherapy, radiotherapy or pelvic surgery are advised to return to the Fertility laboratory a year or so following the completion of their treatment to have a sperm test and review their storage needs.
You will usually be referred to us by the consultant who is treating you. The law requires everybody who stores sperm samples to be tested for viruses such as hepatitis B, hepatitis C and HIV, and these tests are often arranged by your consultant at the time of your discussion about sperm storage. Once the Fertility Laboratory has received your referral details and the results of your blood tests, we will book up to three appointments for you initially.
Your first appointment will take a little longer than others as we will ask you to complete some forms which include information forms for our records as well as consent forms. These enable you to specify the length of time you would like us to store your samples for, how you would consider using your samples in the future, as well as what you would like us to do with your samples if anything were to happen to you. A member of the laboratory team will review the forms with you to ensure that you are fully informed and happy to proceed and you will have the opportunity to ask us any questions or discuss any concerns you may have. This consenting session can last between 30 minutes and an hour.
We will then supply you with a sterile specimen pot and ask you to write your name and date of birth on the pot. You will also be asked to complete a production form. When there is a private production room available for we will show you to the room and advise you where to deliver your sample for freezing. In order for your sample to be produced under optimal conditions, and to reduce any risk of contamination, we ask that the sample is produced by masturbation directly into the sterile pot. Please do not use lubricants/spermicidal condoms/withdrawal method to produce your sample. Once you have delivered your sample to the laboratory you are free to leave.
If you have difficulty producing a sample at the clinic it is possible to produce a sample off site and bring it to us. If you intend to produce a sample off site you must make prior arrangements with us. In addition, the sample must be kept at body temperature and delivered to the clinic as soon as possible and within an hour of production accompanied by a signed production form.
Once we have your semen sample in the laboratory we analyse it to ensure that it is suitable for freezing. Once we have established that there are live sperm present, we add a cryoprotectant to help protect the sperm during the freezing process. We then split your sample into several small containers for freezing and subsequent storage. Your samples are stored in liquid nitrogen storage tanks, located on the premises, and will remain there until you make contact with us to discuss their use or disposal.
Unfortunately, there are times when a man’s sperm sample is unsuitable for storage. This may be because none of the sperm in the sample are alive, or because no sperm were seen at all. In these instances, the sample is discarded, and we will contact you to discuss the next step.
There are a few things to consider before your appointment:
Who to bring with you?
Not everybody will wish to bring someone along to their appointment with them, but you are welcome to if you would like. Please be aware that as we discuss consent and the process of sperm banking, some sensitive issues may arise that you do not wish to discuss in front of your companion. To preserve the confidentiality of our discussions and your treatment, please make it clear to your companion whether or not you would like them present for those discussions.
Where time permits, it is preferable to have a period of abstinence before providing a sample for storage. If you have the time available, please try and avoid ejaculation for 2-3 days before your appointment.
The idea of sperm storage and fertility preservation will mean something different for everyone, so have a think about any questions you’d like to ask at your appointment. It may also be possible to provide you with the consent forms in advance of your appointment to give you a chance to consider them, and any questions arising from them.
Initially, the maximum storage period for anyone storing a sperm sample is 10 years. After 10 years, some men will be able to extend the length of their storage, usually because their fertility has become impaired since they stored their sample (e.g. due to chemotherapy). A doctor will have to provide a statement indicating that this is the case, and ‘check-up’ sperm tests confirm that you qualify for long-term storage.
We use a cryoprotectant which helps to protect the sperm, however, some damage is inevitable and is caused during the cooling and warming processes. The extent of this damage is not affected by the length of time that the sperm are stored for.
During your appointments with us, we will give you the opportunity to discuss options relating to the storage and use of your samples, and we’ll answer any questions you have too. It may be, however, that you would like to explore any fertility-related issues raised during the process further. We have a trained specialist counsellor available, and an appointment can be made for you at any time during the storage of your samples.
It is essential for you to keep us updated with any changes in your circumstances, particularly in relation to your consent forms (e.g. you split up with the partner you named in your forms or recently got married), or your contact details (e.g. you move house). It is important to remember that you can update your consent forms at any time – please contact us.
If you decide you would like to use your frozen samples in fertility treatment, your first port of call is usually your (or your partner’s) GP. They will probably arrange for you to be seen at a fertility clinic, along with your partner, where a series of tests can be carried out to help determine what type of fertility treatment is likely to give you the best chance of a pregnancy.
As well as the investigations that look at your partner’s fertility, before we freeze your sperm sample, we analyse it to give an idea of the quality we can expect when it is thawed out for use. All men will have variable sperm quality to a degree, and men who have been ill can have lower results in their sperm analysis because of this. The analysis of your sperm sample, along with the results of your partner’s investigations, will have a bearing on the types of fertility treatment recommended for you.
Although we do perform fertility treatments here at UCLH, it may be that you receive your fertility treatment at another clinic. The transportation of samples between clinics can be straightforward but does require an exchange of paperwork, so please bear this in mind, and contact us early on in order to start arranging this for you.
Fertility treatments are sometimes paid for by the NHS, but there are some circumstances that will mean that you would need to pay for fertility treatments yourself. These include having children already, or if your partner is over the age of 40. The rules about who can have NHS-funded treatment will be different depending on where you live, so if you are thinking of using your stored samples, you should see your GP, first of all, to find out what you are entitled to.
If you do not think that you would use your samples to start a family with a female partner, for example, if you are in a same-sex relationship, please let us know so that we can discuss future options with you and arrange any additional tests as required.
By law, we need to know what to do with your samples in the event of something happening to you, and there are sections on your consent forms which enable you to specify what you would like us to do with your stored samples in this event. We will honour your preferences indicated in your consent forms – this is why it is extremely important that your forms are kept updated. It is also extremely important that your close ones know to contact us, and if you have consented for your partner to use your samples, that she knows where to find us.
We will maintain the storage of your samples, in accordance with your consent forms, for the time specified in your consent forms. Because circumstances do change, it is vital that these forms are kept updated, and that we don’t lose contact with you. By law, we cannot store beyond the time specified in your forms, and if we cannot make contact with you to discuss the possibility of extending your storage, your samples may need to be discarded.
If you have frozen your samples before starting treatment that could harm your fertility (e.g. chemotherapy), we also invite you to come back to our clinic for a sperm test to assess the effects of your treatment on your fertility. As well as assessing the quality of your sample following treatment, it also provides an opportunity to review your paperwork, updating your forms as necessary. We recommend yearly checkups, the first one at least a year following the completion of your treatment. A proportion of men will regain fertility, sometimes within months and sometimes after years, and it may be that continued storage of the semen samples is no longer required.