Cryopreservation of Human Spermatozoa
Cryopreservation of human spermatozoa is a preventive therapeutic option for patients diagnosed with testicular cancer, Hodgkin's disease, lymphomas and/or other kinds of malignant diseases. Patients who are in the reproductive age group and have not yet established their families may become sterile following chemotherapy, radiation or surgical treatments. Cryopreservation of semen can ensure future fertility for these men.
Extensive studies conducted in the Andrology Research Laboratory have demonstrated the ability of the spermatozoa obtained from patients with cancer to survive the damaging effects of freezing and thawing. We found that the poor quality of sperm before freezing in some men with malignancy could explain the poor post-thaw sperm survival.
Prefreeze or post-thaw quality of semen is not affected by the type of disease, and post-thaw motility could be predicted with prefreeze sperm motility. We have found that successful pregnancy can be achieved when prefreeze semen quality is poor in patients with cancer, even when stored for long periods. Intracytoplasmic sperm injection (ICSI) is a good option in these patients if other assisted reproductive techniques fail. Semen cryopreservation should, therefore, be strongly recommended for all patients with cancer, even when prefreeze semen quality is very poor.
In other studies, we have examined the significance of cryopreserving sperm aspirates at the time of excurrent ductal reconstruction for failure of procedure or subsequent obstruction after initial success and patency. We studied sperm aspirates in men undergoing reconstruction of the excurrent duct, and sperm aspiration or microsurgical epididymal sperm aspiration, and examined these specimens for an association of the sperm with the cause and site of obstruction. We found a lack of association between the cause and site of obstruction with cryosurvival of aspirated epididymal or vasal sperm.
Cryopreservation of microsurgically aspirated epididymal sperm in our program affords couples greater flexibility in future planning and offers them the opportunity to have spermatozoa aspirated in one facility and ICSI performed in another. We have noted high fertilization and pregnancy rates in patients using frozen epididymal sperm aspirates.
Center for Reproductive Medicine
The Cleveland Clinic
9500 Euclid Avenue, Desk A19
Cleveland OH 44195