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.
