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To freeze the sperm, it depends what is the reason for freezing. If the reason for freezing is social, again banking for the future, the better quality the sperm is – that means that the parameters are within what WHO recommends – then we know that the survival of a sperm is better when we warm those sperm or thaw them.
What is important to understand here is that with the freezing of the sperm the good news is that the survival of a sperm going through the freezing process is much better than eggs and has been for many many years. The sperm seem to be a lot more resilient than egg and can survive better through the process of freezing and warming or thawing.
We expect the sperm quality to be quite good in men who don’t have fertility issues so therefore we expect the survival to be very good if they are freezing for social sperm freezing. However, sometimes men have to freeze their sperm due to genetic reasons, due to cancer or other diseases not related to fertility, it could even be varicoceles – if they are freezing for this reason, the better quality of sperm we have, the better survival we have afterwards. We also ask them to come in a number of times to freeze.
Sometimes men don’t produce sperms in their ejaculate and therefore we need to then remove the sperm surgically either through a process called PESA or TESA and then freeze them as a testicular tissue or removing the sperm high up from the tubules that they have in their testicles. We still can freeze those successfully and get them thawed and produce enough sperm to be used for treatments in ICSI.
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When you freeze sperm, there’s no impact on the quality. Giving an example; we’ve been using frozen donor sperm to help women get pregnant for many years. Typically, once you freeze the sperm, the sperm survives very nicely afterward. Now the problem is that some men who are freezing for other purposes such as cancer diagnosis may already have a low sperm count because of the cancer diagnosis. Those cases are very difficult because when you have a low sperm count, the survival of the sperm may not be as good as if your sperm count was healthy. So it’s important that once you’re diagnosed with cancer, go see a reproductive specialist, do a sperm analysis to see what your sperm count looks like. If your sperm count is nice and healthy, freeze your sperm right away. If it’s low or you don’t have any sperm at all, then there are other techniques that we may have to use to extract sperm from the testicle to help you freeze it for the future or freezing testicular tissue as well.
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If we speak about the quality of the sperm, we can say that there is no difference between fresh and frozen spermatozoa. However, the number of spermatozoa, live spermatozoa, decreases after the cryopreservation. This is not a problem in case of normospermic patients or in patients who have spermatozoa because for the ICSI procedure, we are going to wash the sample and we are going to select only the motile spermatozoa. The number of live spermatozoa decreases but the quality of cryopreserved spermatozoa does not change.
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We need to take into account that freezing a sperm can affect the survival rate about almost 50 %. That’s why we do a following test after freezing to see how is the survival of that particular sample.
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So far we haven’t seen any differences between using, for example, a fresh sample and a frozen sample to inseminate eggs. We haven’t seen any differences in the live birth rate between fresh versus frozen ejaculates. Many patients, for example, who are not available on the day of the egg collection and the insemination, decide to freeze sperm as a backup and then the lab will use that frozen sperm to inseminate the eggs and that is absolutely fine. What we always advise patients that they need to be aware of is that the freezing, although, we don’t have any indication that the freezing should be done obviously appropriately in the lab ( that’s very important that the lab know how to properly store and freeze the sample), we don’t have any indication that the freezing affects the DNA quality of that sperm. However, the patients need to be aware that approximately 50% of that motile sperm initially found on the fresh sample, of the fresh ejaculate, will die in a sense that sperm will lose its vitality (to describe this better). So always it is very important when we freeze down a sample, we always keep a tiny amount on the side, we freeze that tiny amount as well and then we thaw it, so we will investigate how much sperm survived the freezing process and we will know how much motile sperm we can anticipate to find on on a thawed vial on the day.
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Freezing would always cause some damage to either eggs, sperm or embryos. However, in the case of sperm in particular because there is usually plenty of sperm and samples even if you do lose some sperm there’s still plenty others to compensate for that low loss even in samples where there is very low sperm concentrations, we do still expect to retrieve some sperm from those samples.
Sperm or the way sperm have their DNA this is so compact that they tend to be quite tough and are able to survive freezing and thawing. There is however the chance of DNA damage caused by the freezing & thawing process, however this is usually unquantifiable and highly debated.
Sperm or the way sperm have their DNA this is so compact that they tend to be quite tough and are able to survive freezing and thawing. There is however the chance of DNA damage caused by the freezing & thawing process, however this is usually unquantifiable and highly debated.
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There is no negative impact or damage during sperm freezing at all. Just keep in mind that we use at least two straws when we decide to freeze sperm freezing in order to make sure that when we perform thawing of this sample, we have enough sperm to use.
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Sperm freezing can significantly affect semen quality, it something we already know. When you freeze sperm, motility lowers and morphology can be affected. Of course you lose some sperm during the process of freezing and thawing. Freezing should be considered in cases where it is important to freeze, for example, when a man cannot provide the semen sample for assisted reproduction as he cannot be physically present when assisted reproduction is performed. Also it is important to freeze for conditions where the result can be male infertility such as Klinefelter syndrome. There are many conditions where for example, men in the military or doing outside work want to achieve pregnancy with their partners, they can freeze their sample. It should be carefully considered with your physician, it’s a possibility that can be chosen but still, yes, we must remember that freezing reduces semen quality and it cannot be avoided.
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If the sample is of good quality, despite the possible alteration of various parameters, such as the spermatozoa count or mobility, after thawing, sperm cryopreservation does not affect the success rate of potential future treatments. But if the sample is of low quality, an alteration of various parameters will be clear and can compromise the results of the future treatments. Then we recommend freezing more samples and doing some tests to check everything is ok.
