Preserving Sperm

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What is sperm freezing?

Sperm freezing is the process of collecting, analyzing, freezing and storing sperm from someone who has testicles. The samples are later used for fertility treatments or donated to other couples or individuals. This overall process is known as cryopreservation and is sometimes referred to as sperm banking.

When should I think about fertility and freezing sperm?

These things are important for transgender and gender diverse youth to start thinking about early, although it may seem uncomfortable or even irrelevant to be thinking about this in childhood or adolescence.  In clinic, we start discussing this, including the risks and uncertainties of gender affirmative treatments on fertility, from the first visit to clinic.  We understand that young people have varying levels of maturity and understanding of their reproductive development so starting these discussions early can help make sure you understand everything.  Of course, we also want to educate and support your family so they can help you in these decisions as well. 

When people who have testicles go through puberty, they begin to make mature sperm. Studies have found that testicular volume, not age or reproductive hormone levels, is the best way to know if a person is able to make sperm. Most testicles produce sperm by the time a person is 13 years old. Even though the sample may be collected at a young age, frozen samples are not damaged by long periods of storage.

Can you freeze sperm before you start puberty?

At this time, there are no effective ways to preserve fertility in pre-adolescent people who have testicles and have not yet started puberty.  They do not make sperm, so there is no sperm to freeze and bank (cryopreserve). Some fertility centers offer experimental techniques called testicular tissue extraction and freezing. Although there are no sperm available to freeze in these samples, the hope is that the stem cells with testicular tissue will be able to later produce mature sperm.  It is expense, experimental, and there is no guarantee that it will be successful.

The cryopreservation process involves:

• Routine screening for infection (HIV, hepatitis and syphilis).
• Providing a semen sample or undergoing a sperm extraction.
• Lab analysis of sperm quantity and quality.
• Freezing of viable sperm.
• Storage of the sperm indefinitely.

Young people are often asked to not engage in sexual activity or masturbate for approximately two days prior to the collection appointment to allow for the best possible specimen.  Sperm is typically collected through masturbation.  Both emotional and physical maturity must be considered. Young teens often feel very anxious about masturbating to produce a semen sample, especially if they must talk about it with their parents or have not done it before. Some teens may have an easier time if they are given medical vibrators and/or an approved, sterile lubricant that doesn’t harm the sample quality.  This can help make the collection into a more “medical” procedure that may be less distressing.  Some clinics offer the option to obtain a sample at home to avoid the distress of being in a doctor’s office for the collection.

Once a semen sample is provided it is tested for sperm quantity, shape, and movement within each specimen.  If sperm are not present in the sample or if the patient is unable to ejaculate, a surgical retrieval to remove sperm directly from the testicle is another option.

Next, the samples are separated into multiple vials to be frozen. Lab technicians will use specialized cryoprotectant (“anti-freeze”) agents to help preserve and protect sperm cells. The frozen sperm is then stored in the lab until needed. When the time comes, the sperm is thawed, washed, and tested for mobility prior to use.

Who should consider freezing sperm and why?

The primary benefits of freezing sperm are to allow a patient who has testicles to preserve fertility by using his sperm at a later date or to give an infertile couple, an infertile individual, or a lesbian couple a chance to conceive.  This is important to consider before or during treatment with gender affirming hormones, and before surgical removal of the testicles.

Risks involved in freezing sperm

There are no risks or side effects to collecting semen samples naturally (through masturbation). If surgical extraction is required, there are small risks, as with any surgery, such as bleeding or discomfort.

Sperm freezing has been successfully used since 1953 to help individuals conceive healthy babies. The process is safe, standardized, and continues to improve as technology advances.

The primary concern with sperm freezing is that not all sperm survive the freezing and thawing process. However, as most semen ejaculations contain an appropriate number of sperm, the chance of having enough healthy sperm for fertility treatments is very high. The capability of the surviving sperm cells to fertilize an embryo is not jeopardized during the freezing or thawing process. Cryopreservation is considered to have no time limit, and stored sperm as old as 20 years have been used to create healthy babies.

How much does it cost and does insurance cover it?

The costs can vary, the average is often around or less than $1000 for the testing, obtaining and analyzing a sample, and then freezing it.  Often insurance will cover some of that cost, but it is rare that insurance covers all of it.  In addition, there is usually a storage cost of about $300-500 per year that can add up over time (and not usually covered by insurance).

At Lifespan, the most recent rates we were quoted for these services, include:

            Consultation               $180-250                    Storage Fees    1 year: $300

            Freezing Fee                $175                                                    5 years: $1200

            Washing Fee               $125

            Blood Work                 $185-220       

            Total One-Time Cost   $700-1000

Information Taken from https://fertility.womenandinfants.org/ and https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/fertility-and-sexual-side-effects/preserving-fertility-in-children-and-teens-with-cancer.html

Where can I get sperm banking done?

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What is it like?

Article: Fertility & fertility preservation for trans women

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