There are lots of reasons people look to preserve their fertility into the future. 

Sperm may be frozen as back up for fertility treatment; as an ‘insurance’ before a vasectomy; or for people who think their fertility may decline before they are ready to have children. It may be a prudent decision to preserve fertility until after cancer treatment or gender-affirming hormone treatment (GAHT).

Access to publicly funded fertility preservation for the retrieval, freezing and long-term storage of sperm is available for people whose fertility will be permanently impaired by publicly funded treatment for medical conditions, such as by cancer treatment or GAHT.

Options for fertility preservation may exist prior to and after cancer treatment, however it is very important that if you have time before you start your treatment, you speak with a fertility specialist to ensure you have the full picture. Many options for fertility preservation may be funded through the public health system.

One year after the completion of your treatment you can do a sperm analysis to check if your fertility has been affected. If the sperm looks normal, we will give you the option to continue storage of your sperm or dispose.

• Planning a vasectomy? It’s useful to consider having a back-up plan in case things change in future. This is more common than you might think.
• If, for whatever reason, you think your fertility may be in decline.
• Oncology treatment. Many cancer therapies have the potential to affect your ability to conceive naturally.
• Gender Affirming Hormone Therapy (GAHT). Sperm preservation allows those undertaking GAHT to keep their options open for having a family in future.

Your Oncologist, Endocrinologist or other specialist will be able to help you with more information.

Seeing a doctor
You don’t need to see a Fertility Associates doctor if you want to freeze sperm, although you may want to if you have any questions or want to explore how you may want your sperm to be used in the future. 

Blood tests
Prior to storing sperm, you will need to do a blood test to screen for HIV, Hepatitis B and Hepatitis C. This is a standard test that we do for all people undergoing fertility preservation. This is because there is a theoretical risk of cross-contamination of viruses from one sample to another, although it has never been reported. If any of these tests did come back positive, it would not stop you from being able to store sperm. Quite often your referring doctor will have already done these tests, which we can acquire directly from them.

Sperm freezing – what to expect
Sperm freezing is very straightforward. You produce a sample on the day and we freeze it all for future use. Samples can be collected at home, in hospital (if you are an inpatient) or ina private room specially set aside at the fertility clinic. We prefer that your sample is collected onsite at the clinic but if you are bringing your sample from home this can be arranged with the lab staff. Note that it needs to be at the clinic within one hour of being produced.

Many people will have enough sperm in one ejaculate for several IVF cycles. If there are enough good quality sperm after thawing, then the first approach may be to try IUI treatment, keeping some sperm in reserve for IVF later, if IUI is not successful. If you want to consider IUI as an option, you will almost certainly need to freeze three or more semen samples.

Costs
Sperm freezing before cancer treatment or GAHT is free of charge for those who do not already have a child. We do need a referral letter from your Oncologist, Endocrinologist or other specialist indicating that your cancer and/or treatment could impact your fertility in the future. For those covered by public funding, sperm can also be stored for up to ten years free of charge if your ability to conceive naturally is permanently affected.

Consent
You will need to sign a consent form as part of freezing sperm. The consent form covers:
• time limits to storage
• who we can contact if we cannot reach you
• your decision on what should happen to your frozen sperm in the event of your death.

You can choose to dispose of your frozen sperm or keep your frozen sperm in storage and make it available to a named person for potential future use in fertility treatment.

When you are ready to start a family, it’s a good idea to visit one of our doctors to discuss your treatment options with frozen sperm. There are two types of treatment when using frozen sperm – the choice depends on the number and quality of the sperm collected, and whether the cycle includes donor oocytes and/or surrogacy.

• Intra-uterine Insemination (IUI).  This is the simplest technique and involves sperm being placed into the uterus during the fertile part of the cycle. This treatment requires a high number of good quality sperm. If you want to consider this as an option, you may need to freeze more than one sperm sample.
• In-vitro Fertilization (IVF) with or without Intra-Cytoplasmic Sperm Injection (ICSI) IVF is a more complex option. It involves eggs being collected and then fertilized outside the body by either mixing the sperm and eggs together or injecting a single sperm into an egg (ICSI). The resulting embryo is then put back into the uterus. The benefit of this type of treatment is that it requires fewer good quality sperm and therefore usually one sperm sample is enough for several IVF cycles.

You may be eligible for public funding if you need fertility treatment.

When men have sperm production in the testis but the number produced is too few for them to appear in the semen this is called ‘non-obstructive’ azoospermia. In about 40% of men with non-obstructive azoospermia sperm can be retrieved, but it can be difficult to predict who will have sperm and who will not.

If there is a blockage in the vas deferens or in the epididymis outflow tract – from infection, vasectomy or even congenital absence of the vas – this is called ‘obstructive azoospermia’. It is nearly always possible to retrieve sperm from the epididymis or testis from these men.

Read more about ICSI and SSR here.