Our program is available for patients 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 clients 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 their 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, the residual effects of the anesthesia and post-surgical medications. We strongly recommend that the patient initiate banking prior to, or within one week following surgery if they are able. In patients 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 their sperm for future use are either voluntary or involuntary sterilization.
Voluntary Sterilization - Patients 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 vasovasostomy; this is a reversal of the vasectomy. Many factors determine the percentage of success of a vasovasostomy: 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, this is a procedure when the sperm are surgically retrieved from the epididymal area and then 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 those 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 patients 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 Banking and 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 one has to travel out of town or can't miss work on the day his partner/spouse 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 when faced with possible sterilization one may desire to preserve their sperm, such as working in jobs that involve exposure to harmful chemicals or radiation, military service, etc.
Procedure for banking sperm
All patients are seen at International Cryogenics, Inc. on an appointment basis only. Usually 1or 2 days is all that is required to get an appointment. Initial banking appointments usually take approximately one hour. This appointment includes a consultation to review necessary paperwork and contracts. We have the patient collect a urine specimen for the required Chlamydia & Gonorrhea testing. Next the patient collects their semen specimen. To ensure the highest quality semen specimen and for directed donations the specimen should be collected at our facility. We have private donor rooms that are located in the back of our office. The rooms have a private living room style atmosphere. There are magazines to aid in the collection and a Wi-Fi password is also provided. The specimen is collected by masturbation into a sterile specimen container.
Patients then get their blood drawn for the sexually transmitted disease testing that is required for the type of banking that the client chooses Sexually intimate partner use or directed donor use.
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.
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 within the United States after all required testing and paperwork has been completed. 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 the specimens we will ship them 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 will 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 the recipient seek a fertility specialist when utilizing frozen semen specimens. Patients bank a limited number of specimens so it is very important that the recipient go to a physician that can accurately determine ovulation, fertility status, etc. They are also educated in handling and thawing the specimens properly which 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.
The client that banked their sperm at our facility is the only person that can legally withdrawal the specimens. The client can sign a document giving the recipient the right to ship and utilize the specimens after all testing and documentation is complete. The client/directed donor can change their mind and decide they no longer wish for their specimens to be utilized. We will honor the client’s request regardless of who was financially responsible for paying for the banking, lab fees and storage fees. Legally the specimens always belong to the client that banked them.
We require 10 days’ notice for the first withdrawal of your specimens. Upon receiving a written release from the client we will ship the specimens to a licensed physician only. The signature on the release form must be notarized. In the event of a client's demise, ICI will be unable to release his specimens, unless they are willed to a named recipient. If the client does not have a will, a signed notarized document stating their wishes to release their frozen semen specimens to a named recipient in the event of their demise will be accepted if all required testing and if required quarantine of the samples has been completed.
ICI will not store your specimens unless all contracts are signed and witnessed by ICI on the date your initial specimen is banked.
Note: If any of the required sexually transmitted disease testing has a positive result ICI may not be able to continue banking. If banking as a directed donor they may be deemed ineligible to be stored or released for use.