Client Deposit Banking

Our program is available for men who will undergo voluntary or involuntary loss of fertility through a surgical procedure or therapy, which may render them sterile. We are often faced with young men that are very frustrated with the lack of disseminated information concerning semen banking. Many times they have had to obtain this information from the media or through extensive investigation. Often the information comes too late for the patient to have enough time to bank his semen.

The earlier the patient is referred for sperm banking correlates with a greater success rate. Approximately three weeks after surgery requiring general anesthesia the semen quality may start to deteriorate. This lasts about 3-4 months and is due to the shock from the surgery and the residual effects of the anesthesia and post surgical medications. We strongly recommend that the patient be advised to initiate banking prior to, or within one week following surgery if he is able. In males who will undergo a vasectomy, it is recommended that they allow at least two weeks prior to surgery for sperm banking

It is not advised to bank specimens after chemotherapy or radiation has been initiated. Some patients out of necessity will elect to bank after an initial chemotherapy or radiation treatment. We strongly recommend that they talk to a genetics counselor prior to banking or using their stored specimens. Once chemotherapy or radiation therapy is started there is a risk of genetic damage to the sperm that can result in a birth defect in the child.

We recommend patients bank a minimum of five ejaculates. The average pregnancy takes four to five cycles of inseminations before conception occurs. Some patients may conceive after only a few cycles and others may take longer. Storing a minimum of five ejaculates usually allows enough vials for at least five ovulatory cycles. Patients who have banked a minimum of five ejaculates prior to or within the first three weeks post surgery, and have subsequently used their stored specimens, have had a good success rate obtaining a pregnancy. The minimum time it takes to bank five ejaculates is ten days to two weeks prior to surgery or therapy. This allows the recommended 48 - 72 hours of abstinence between appointments to allow the sperm count to recover. If time allows, storing more than five ejaculates is recommended. Out of necessity, some patients will elect to bank less than five ejaculates. This may reduce their success rate, but still offers them a possibility of future children.

Long Term Banking

The majority of instances in which one chooses to preserve his sperm for future use are either voluntary or involuntary sterilization.

Voluntary Sterilization - Men undergoing a Vasectomy are counseled regarding the permanence of the procedure. Invariably a percentage will wish to have children at some future date. This may happen as a result of a divorce and remarriage, death of a child etc. If there is even the remote possibility that a child may be desired at some future time, there are a few options that are available. Semen specimens can be frozen prior to sterilization and then used for artificial insemination. Another option is a vaso-vasotomy; this is a reversal of the vasectomy. Many factors determine the percentage of success of a vaso-vasotomy: the type of procedure that was used when the vasectomy was performed, the number of years between the vasectomy and the reversal, and if there is scar tissue that makes a reversal unsuccessful. There is also a procedure called epididymal retrieval. Epididymal retrieval is when the sperm are surgically retrieved from the epididymal area and used in an IVF procedure. One has to weigh the expense, success rate, and discomfort associated with a reversal or retrieval attempt, compared to freezing specimens ahead of time.

Involuntary Sterilization - Sperm banking is an important option for men that have not established a family, and are faced with the impending prospect of being rendered sterile due to various medical treatments. A few of these medical treatments include surgery for testicular tumors, lymph node dissection, prostate surgery, transplant surgeries or prior to radiation treatments, chemotherapy and or other medications that may impair fertility. Advancements in the field of infertility have made it possible for men with very poor quality specimens due to illness or otherwise to achieve pregnancies with their frozen specimens. Freezing sperm prior to involuntary sterilization gives patients the option of preserving their fertility for future use. Patients may never need to use their frozen specimens, if their course of treatment did not cause sterility. Research has shown in many cases cancer treatments do cause temporary or permanent sterility.

Banking is not a guarantee that conception will occur with the stored specimens, but it is successful for many couples and provides an option for preserving future fertility. Frozen sperm has been successfully used to produce pregnancies forty to fifty years after it was initially frozen and can be stored indefinitely.

Short Term Banking

There are reasons that patients may wish to store their specimens short term maybe only days, weeks or months. Short-term storage can be utilized prior to an IVF procedure to insure an adequate number of sperm for the procedure. Patients that are currently undergoing fertility treatments may opt to store their specimens for future inseminations in the event that the husband has to travel out of town or can't miss work on the day his wife is ovulating.

Short term banking after a successful vasectomy reversal helps to insure fertility in the event that scarring causes a blockage before a conception has occurred. Patients that are having an epididymal retrieval procedure or other type of male reproductive surgery may opt to have a family member transport a specimen to our facility from the hospital the day of the procedure to store any sperm that may be retrieved during the surgery, for use in a future fertility procedure.

There are other instances where men not faced with sterilization may desire to preserve their sperm, such as working in jobs that involve exposure to harmful chemicals or radiation, military service, etc.

Directed donor

 

Patients that are banking as a directed or known donor must have a complete physical prior to the first banking appointment. The physical form that we provide must be completed within 30 days prior to the initial banking appointment and signed by the directed donors physician. Directed donors must also complete the medical history profile packet  we will provide and bring it along with the completed physical form to their first banking appointment.

Patients that are banking as a directed donor or known donor are tested for the following sexually transmitted diseases at the time of their first banking appointment.

HIV 1&2 Antibody, HIV NAT, HTLV 1&2, Hepatitis B Sag, Hepatitis B core,

Hepatitis C NAT, Hepatitis C Antibody, Syphilis, Gonorrhea, Chlamydia,

CMV, Blood type

We also recommend consulting with the physician that will be utilizing the specimens to find out if there is any additional testing that he or she may require.

The specimens are then quarantined for a minimum of 6 months  If the directed donor completes his banking within 7 days of his initial blood work  the directed donor must be retested for many of the sexually transmitted diseases listed above prior to the  release of the specimens for use.  If he banked more than 1 or 2 ejaculates and his banking was completed more than 7 days from the date of his initial blood work up, all testing must be repeated per FDA guidelines.   

Directed donor specimens are not represented or screened the same as International Cryogenics, Inc. anonymous donor specimens and ICI, under no circumstances will accept responsibility for any illness transmitted to the recipient, and or child or any abnormal birth defect incurred from the use of the directed donor specimens. All legal aspects of paternity, financial obligations, etc. is the responsibility of the directed donor and the recipient. 

More stringent standards are required for anonymous sperm donors including a Karyotype for Chromosome analysis, Cystic Fibrosis, more extensive blood work and cultures, fertility testing, interviews and depending on the ethnic background of the donor they may also require Tay Sachs, Sickle Cell ,Thalasemia or additional genetic testing.

Procedure for banking sperm

All patients are seen at International Cryogenics, Inc. on an appointment basis only. Usually one to two days notice is all that is required to get an appointment. Initial banking appointments usually take approximately one to one & one half hours. This appointment includes a consultation to review necessary paperwork and contracts. We have the patient collect a urine specimen for the required Chlamydia testing. Next the patient collects his semen specimen. To ensure the highest quality semen specimen possible, the specimen should be collected at our facility if possible. We have very private donor rooms that are located in an area away from our regular office setting. The rooms have a small living room style atmosphere. There are magazines to aid in the collection. The specimen is collected by masturbation into a sterile specimen container. Patients can take as long as needed to obtain their specimen.

Patients then get their blood drawn for the required communicable disease testing that is recommended by the American Association of Tissue Banks. The testing includes HIV 1&2 (AIDS Virus), HTLV 1 & 2, Hepatitis B, Hepatitis C, Syphilis, Gonorrhea and Chlamydia testing. This is the minimum testing required for use on a spouse or an intimate partner. The patient is then taken on a short tour of the lab to explain how the specimens are frozen, labeled, stored and monitored twenty four hours a day. Subsequent appointments are much shorter.

A semen analysis is done on each specimen that is collected to determine the quality of the specimen. A cryo-preservative is added and the specimen is divided into small vials that are labeled with a number of identification features. The specimens are frozen and stored in liquid nitrogen (-325 F) for maximum integrity. A few drops of the specimen are frozen in a separate vial. This vial is used for the post thaw semen analysis to determine how the specimen survived the freezing process. On average 10% of the sperm will die during the freezing process. Specimens that have a lower quality before freezing may lose a higher percentage. Patients can call the next business day to get results on their specimen.

Patients need not feel an urgency to use their specimens in a predetermined time limit. Specimens that are stored at a very consistent temperature, submersed in liquid nitrogen can be stored indefinitely. Storage tanks are filled with liquid nitrogen on a daily basis to insure the liquid level is above the level of the specimens at all times. The storage tanks do not run on electricity so a power outage does not affect the storage tanks in any way. We have liquid level alarms on all of our storage tanks that are monitored on a 24-hour basis.

Specimens can be shipped to physicians anywhere in the United States. Moving out of state does not necessitate that your frozen specimens be moved with you. Specimens can remain in storage. When you are ready to use them we will ship your frozen specimens to a physician of your choosing. Specimens are shipped in a liquid nitrogen shipping canister. The canister keeps the specimens frozen for seven days. We ship the number of vials the physician plans to use that ovulatory cycle. If the patient's physician has a liquid nitrogen storage tank in their office we can ship as many specimens as requested. However, we don't recommend shipping all of the specimens in one shipment in the event that something would happen during the transportation.

We highly recommend that couples seek a fertility specialist when utilizing frozen semen specimens. Patients have a limited number of specimens; it is very important that they go to a physician that can accurately determine ovulation. Handling and thawing the specimens properly is very important to insure the highest quality specimen possible. Evaluating the quality of the frozen specimen and the fertility status of the female recipient to determine the best reproductive method needed leads to the greatest chance of success.

We require 10 days notice for the first withdrawal of your specimens. The man who has banked his sperm in our facility is the only one who can withdraw the specimens. Upon receiving a written release from the client, we will ship the specimens to a physician only. The client depositor is the only person that can authorize the release of his specimens. The signature on the release form must be notarized.

In the event of a client depositor's demise, ICI will be unable to release his specimens, unless they are willed to a named recipient. If the client depositor does not have a will, a signed notarized document stating his wishes to release his frozen semen specimens to a named recipient in the event of his demise will be accepted.

ICI will not store your specimens unless all contacts are signed and witnessed by ICI on the date your initial specimen is banked.

Options will be discussed with patient if any of the required blood tests or cultures have a positive result.