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Sperm Freezing for Post-Cancer Fertility
April 15, 2013
Both men and women can face fertility compromising treatments, including chemotherapy. Given that the American Society for Reproductive Medicine (ASRM) has lifted the experimental title from egg freezing, female fertility preservation has become a widely discussed topic. However, sperm freezing is less often discussed despite being an easy and inexpensive option for men to preserve their fertility.
Michael L. Eisenberg, M.D., Director of Male Reproductive Medicine and Surgery at Stanford Fertility and Reproductive Medicine Center says that sperm freezing is, in some ways, an insurance policy for the future fertility of a man about to undergo cancer therapy. “Certainly when we are talking about cancer and gonadotoxic therapies, it is a reasonable sort of insurance policy for a male patient to freeze his sperm,” he says. Whether a male cancer patient will need to use that frozen sperm in the future or not, it is a smart approach to consider sperm freezing before undergoing treatment that could pose a threat to fertility.
Studies have suggested that oncologists do not address fertility preservation with their patients as often as they should, but Dr. Eisenberg believes the partnership between fertility doctors and oncologists is improving. “There are barriers to knowing when to have the talk about fertility preservation. When is too early? When is too late? Pediatric oncologists can work with a young male patient to retrieve sperm and there are techniques for assisted ejaculation or surgical retrieval of sperm if the patient is uncomfortable. There is also a barrier of knowing when a man might be interested in fertility preservation, but in general it is always a good question to ask,” Eisenberg advises.
The process of freezing sperm for fertility preservation requires no lead time. The sperm retrieval could be performed at a fertility center or deposit could be made at a sperm bank and the patient could provide several samples before undergoing cancer therapy. “The cost barriers are lower for male fertility preservation than female fertility preservation,” says Eisenberg. The cost of fertility preservation for men is just a few hundred dollars up front and a few hundred for frozen storage based on an annual or several year package. For women, egg freezing and storage could cost several thousand dollars.
The degree of fertility risk depends on the type of cancer and recommended course of treatment. Dr. Eisenberg explains that patients who undergo stem cell transplants are unlikely to have sperm after treatment due to the intensity of chemotherapy. For others, there is between 60-90% chance of recovery. “At the time of diagnosis, between 10-15% of men are azoospermic (meaning they have no sperm in their semen). This can be the due to the fact that the body is weakened or affected by illness, so the body shuts down that function,” Eisenberg states. However, these patients tend to have sperm present intermittently and any amount of sperm can be retrieved for use after cancer therapy.
Overall, sperm freezing is a cost effective it is in the male patient’s best interest to be aware of the options for fertility preservation and to proactively think about the future of their fertility.