Client Deposit Banking - Preserving Your Future Fertility
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.
Male to female hormone therapy/gender reassignment surgery
Sperm banking is a great option for Transgender patients that are planning to undergo male to female hormone therapy/gender reassignment surgery. Banking sperm prior to treatment allows patients the possibility of having their own biologically related children by preserving their fertility prior to treatment. Sperm banking should be completed prior to starting hormone therapy as these medications can have a detrimental effect on sperm production. There are two different ways of banking sperm prior to initiating therapy/surgery. One is long term Directed Donor Bankingand the other is Sexually Intimate Partner (SIP) banking.
Directed donor banking(recommended): Directed donor banking means that the banked semen specimens can be used on any individual of choice in the future. This could be a non-sexually intimate person such as a surrogate, gestational carrier or friend. They could be used on sexually intimate partner as well. Banking for directed donor use requires the patient to have a physical at their personal physician’s office and fill out a medical history form within 7 days of their initial banking appointment. On the day the initial specimen is banked patients are required to have the FDA required panel of sexually transmitted disease testing (STD) completed. The specimens are then required to be quarantined for a minimum of 6 months from the date the final specimen is banked. The patient would then be required to return to our lab to have the FDA required STD panel of tests repeated. Once all test results are completed the specimens could then be released for use on any female recipient in the future. Many transgender patients may not know at the time of their transition who they will need to use their banked semen specimens on in the future. Banking the sperm as a directed donor opens up many avenues for use in the future and does not require them to make that decision at the time of banking/transition.
Sexually intimate partner banking (SIP): Sexually intimate partner banking means that the banked sperm could only be used on the patient’s sexually intimate partner in the future. Patients that banked for SIP use are not required to have a physical/medical history completed, sexually transmitted disease test panel is an abbreviated version of the Directed donor panel and the specimens are not required to be quarantined for 6 months. Unfortunately, if the patient’s spouse /intimate partner has fertility issues and cannot conceive or if the banking patient changes their mind about using their specimens on a sexually intimate partner in the future they would not have the option of using them on a surrogate or anyone other than their sexually intimate partner.
For additional information or to set up an appointment please call our office at 248-397-8449. We can provide the required physical and medical history forms that need to be completed for directed donor banking and give instructions that need to be followed in the days prior to your appointment so that the highest quality specimens possible can be obtained.
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.