Cryopreservation of Spermatozoa

Cryopreservation is a technique that keeps the cells and tissues in a vital state, using cryogenic temperatures (196 C). Despite the first experiments of sperm preservation with snow dating back to the eighteenth century, it was only the discovery of the protective role of glycerol against freezing damage in the twentieth century and the use of liquid nitrogen that started the era of modern cryobiology. The use of cryoprotectants and adequate cryopreservation methods (rapid or slow freezing procedures) allow to prevent freezing damage and maintain the cells in a state of “suspended animation” which will preserve for a long time. Sperm Bank is a medical facility characterized by two purposes: to preserve the patient’s fertility and to access to assisted reproduction techniques (ART). There are many indications (neoplasms, autoimmune diseases, urological pathologies) but, as a general rule, semen or testicular tissue cryopreservation must always be executed before any therapy, which may interfere with either spermatogenesis and genome integrity or ejaculation mechanisms. Also, it is possible to cryopreserve a patient’s semen to facilitate access to ART. The activities of a Sperm Bank are strictly regulated by the current EU legislation. This involves quality standards, structural and personnel requirements, archive, traceability, storage, and distribution of human tissues and cells. These rules consist in the adoption by the various Member States of Directive 2004/23/EC and following (2006/17/EC and 2006/86/EC) issued by the European Parliament

Monitoring fertility (semen analysis)by cancer survivors who banked sperm prior to cancer treatment

Study question: What medical and psychological variables predict why men with banked sperm do not return for semen analysis after their cancer treatment has ended?Summary answer: Men who decline the offer of semen analysis are less likely to have reported adverse side effects during cancer treatment, and have a more negative experience of banking sperm and a more negative attitude towards disposal of their stored semen than those who attend.What is known already?: Previous authors have noted that male cancer survivors seem reluctant to have their fertility tested after their treatment has ended. Moreover, the utilization rates of banked sperm are very low (,10%) and the majority of samples are kept for many years without being used.Study design, size and duration: A cross-sectional study of 499 cancer survivors who were sent a questionnaire about their views on sperm banking, fertility and post-treatment semen analysis between April 2008 and December 2010.participants and setting: Men (aged 18–55 years) who had banked sperm in Sheffield and Nottingham (UK) prior to gonadotoxic treatment for cancer more than 5 years previously.Main results and the role of chance: Completed questionnaires were received from 193 men (38.7% response rate) whose samples had been banked for 9.18+3.70 years (range = 4.94–26.21) and whose current age was 35.08+7.08 years (range = 21.58–54.34; mean+SD). One-third (35.8%) had never attended for semen analysis. In multivariate analysis, the odds of not attending for semen analysis were significantly greater among men who did not experience adverse treatment side effects [odds ratio (OR) = 5.72,95% confidence interval (CI) = 2.10–15.56], who reported a more negative experience of banking sperm (OR = 1.82, 95% CI = 1.17– 2.82) and a more negative attitude to disposal of their stored semen (OR = 1.56, 95% CI ¼ 1.01–2.42).Limitations and reasons for caution: Only 38.7% of those eligible agreed to take part. We do not know the characteristics of men who declined to take part, if they agreed to attend semen analysis without completing the questionnaire or whether they had chosen to have semen analysis performed elsewhere (e.g. private sector). Some of the measures used (e.g. experience of banking sperm)relied on men’s recall of events many years previously.Wider implications of the findings: New strategies are required to encourage these men to engage with fertility monitoring programmes if sperm banks are to be used cost-effectively and men are to be given appropriate fertility advice.Study funding and competing interests: This paper was supported by funding from Cancer Research-UK to C.E.,A.A.P. and R.R. (C481/A8141). The views expressed are those of the authors. No competing interests declared