Sperm Freezing for Cancer Patients: A Step-by-Step Guide

Right from the word go, cancer treatments can negatively impact a person’s fertility. For many patients who had hoped to build their families, this can come as discouraging news. However cancer patients can still build their families after completing their treatments using assisted reproductive technologies (ART). Typically, cancer patients who wish to have children in the future have an option to preserve their fertility prior to beginning treatment. This is called oncofertility, or fertility preservation for cancer patients. Men can freeze their sperm ahead of their cancer treatment and the process is a straightforward one for the patient.

Why Sperm Freezing is Recommended Before Cancer Treatment

The reason that sperm freezing is recommended before cancer treatment is because of the side effects of cancer treatment. As well, the type of cancer, the medications used, the duration of treatment and how aggressive the treatment is play a part in how fertility will be affected thereafter. Chemotherapy and radiation therapy tend to damage sperm cells, testicular tissue and DNA resulting in complications during pregnancy or birth defects if such sperm were used in conception. Therefore, speak to your doctor regarding your family building goals as soon as possible before you begin your treatment.

The Sperm Freezing Process

The process of freezing sperm or banking sperm  for cancer patients is similar to the process used in ART therapies. Sperm is collected from the patient, it is examined for health and anomalies, and then it is frozen using cryopreservation technology. Frozen sperm has been used in intrauterine insemination (IUI), in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatments with success.  Sperm freezing is about selecting the healthiest sperm that will give the best chances for fertilization and pregnancy outcomes. Therefore a blood test will typically be the first step, where infectious diseases and hormonal levels will be examined. The other aspect will be to collect a fresh sperm sample from the patient. 

A sperm sample is collected by masturbating and ejaculating into a sterile container supplied by the fertility center. Sperm sample collection can also be done in the comfort of one’s home, but the sample must be maintained at room temperature and delivered within 24 hours for the sample to be usable. As well, to prevent sample contamination, one must not use moisturizers or lubricants during the sperm collection process. 

The next step will be to conduct a sperm analysis for health markers such as concentration, mobility and morphology, as well as genetic tests to check for DNA anomalies if necessary. The sperm will also be cleaned to remove any debris, toxic or unwanted materials including sperm that are not viable. The sperm will be separated from the semen and then be divided into several vials for cryopreservation storage in separate storage tanks.

Storage and Thawing Success Rates

Cryopreserved sperm can be stored for a very long time, but it has not been studied exactly how long this could be and what the effects are on the viability of sperm thereafter. That said, when ready for use, sperm are thawed gradually in order to prevent damage to the cells. After this the sperm are evaluated again to confirm that they are still viable and undamaged. Since they are cleaned of harmful substances prior to freezing them, studies have shown that more than 50 percent of sperm cells tend to survive the thawing process.

How Long Can Sperm be Stored?

At the introduction of sperm freezing the cut off storage time was 10 years. However with people’s family building needs changing, for some people, it will be decades before they begin family building. In light of this, among other factors the law now allows people to preserve their sperm for a maximum of 55 years. The conditions however, are that they must renew their consent for storage every 10 years. Failure to renew consent could result in sperm being discarded. 

The law aside, the cost of sperm storage is paid as an annual fee, therefore one must consider how long they want to store their sperm in light of the costs that they will incur for this service. Failure to pay for storage may also result in sperm being discarded. If one’s address or contact details change, they must update the clinic to prevent being unreachable in the event that the clinic would need to contact them. 

Insurance and Cost Considerations

Insurance providers are required by the law in most States to cover oncofertility for cancer patients. How much one is covered depends on the insurance provider and the insurance plan one is on. This conversation ought to be had directly with insurance providers. As well grants, financial aid and discounted rates are available for cancer patients to freeze their sperm. 

That aside, the actual costs of sperm freezing include $50 to $200 for sperm collection and a basic sperm analysis, or $150 to $400 for a more comprehensive evaluation; $300 to $500 for DNA tests such as a DNA fragmentation test; $200 to $1,000 for processing and freezing, and $100 to $500 annually for storage. 

FAQs

Can cancer treatment affect sperm production?

Yes. Cancer treatments such as chemotherapy, radiation, and some surgeries have an impact on sperm production. Some patients may recover their fertility but others may not depending on the type, dosage, and duration of treatment, as well as the age of the patient. 

How long can sperm be frozen?

Studies have shown that sperm quality and viability do not decline even after decades of storage, with the longest duration being more than 20 years resulting in successful conception.

Can I use frozen sperm for IVF?

Yes! In many cases, frozen sperm is used for IVF since there is no difference in success outcomes whether the sperm had been frozen or was used fresh. IUI and ICSI are other treatments where frozen sperm can be used for treatment.