Male germ cells (sper­ma­to­zoa) can be cryo­p­reserved (frozen) prior to chemo­ther­apy or radio­ther­apy and later be used, in the case of a loss of function of the male gonads (testes), for a medically assisted repro­duc­tion (MAR) procedure, in order to conceive an own child.

Cryo­p­reser­va­tion of sperm is an estab­lished procedure and is done in all fertility and andrology centres. For this purpose, one or more sperm samples must be provided and are stored frozen.

Inde­pend­ent of the number of sperm within the ejaculate, from normal to only few, cryo­p­reser­va­tion should be offered as only a few vital sperm are suf­fi­cient for later MAR treatment with (nearly) equal success rates.

If no sper­ma­to­zoa can be found in the ejaculate (azoo­sper­mia) small pieces of testic­u­lar tissue, con­tain­ing sperm can be retrieved and then cryo­p­reserved for later use. The testic­u­lar biopsy for testic­u­lar sperm extrac­tion (TESE) is performed under local or general anaes­thesia. Optimally, the biopsy is done using a microsur­gic­al or micro­scop­ic­ally assisted technique (micro-TESE, mTESE); altern­at­ively, mul­ti­loc­u­lar biopsies from different areas of the testis (standard TESE) could be taken. This treatment should only be performed in spe­cial­ized centres and has minimal surgical risk.

There are no direct risks for the sperm quality asso­ci­ated with the cryo­p­reser­va­tion of sperm. However, it may be necessary to postpone the ini­ti­ation of onco­lo­gic­al therapy for a few days due to the surgical intervention.

Detailed inform­a­tion and a bib­li­o­graphy can be found in the Fer­ti­PRO­TEKT booklet “Indika­tion und Durch­führung fer­til­ität­s­pro­tekt­iver Maßnahmen bei onko­lo­gis­chen und nicht-onko­lo­gis­chen Erkrankun­gen”, 2nd revised edition 2020, which was written by members of the Fer­ti­PRO­TEKT Netzwerk e.V. and is available free of charge (in German).

(Chap. 3.8)

An english version can be bought: Fertility Pre­ser­va­tion in Onco­lo­gic­al and Non-Onco­lo­gic­al Diseases a practical guide by Michael von Wolff & Frank Nawroth ISBN 978–3‑030–47567‑3 from Springer.com

Part III.VIII page 229ff