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Cryopreservation of Spermatozoa and Testicular Tissue Including Autotransplantation of Germinal Epithelium

  • Chapter
Andrology for the Clinician

Summary

Assisted reproduction techniques have widened the indications for human sperm cryopreservation, because semen quality is no longer a limiting factor. Therefore, cryopreservation can now be used more often than in the past by cancer patients for the purpose of fertility protection.

Since the fertilizing capacity of cryopreserved testicular and epididymal spermatozoa is comparable to that of ejaculated spermatozoa, the most evident advantage of cryopreservation techniques is that active spermatogenesis can be identified before the female partner undergoes any stimulation protocol.

  • Cryopreservation of human ejaculates is a well-established medical procedure to maintain the fertilizing potential of spermatozoa during storage in liquid nitrogen.

  • Pregnancies have been achieved with semen samples cryopreserved for more than 15 years.

  • There is no doubt that pre-therapy storage of semen from cancer patients is an important medical task, all the more since the prognosis and life expectancy of those with Hodgkin’s disease and testicular tumours is very good today.

  • Since intracytoplasmic sperm injection (ICSI) requires only one living spermatozoon per oocyte, cut-off values of standard semen parameters prior to cryopreservation of samples are no longer necessary.

  • There is no marker available to predict the freezability of individual semen samples; in general, however, the survival rate 1 h after thawing of frozen semen is between 50 and 60%.

  • Cryopreservation of ejaculated, epididymal and testicular spermatozoa does not affect ICSI results in terms of fertilization and pregnancy rates; however, the data about testicular spermatozoa are contradictory because single studies have reported reduced fertilizing capacity of testicular spermatozoa with no decrease in pregnancy rates.

  • Amajor problem of cancer patients is that 50% of them may have a disease-intrinsic suppression of spermatogenesis.

  • Sperm cryopreservation should also be recommended to oncological patients younger than 15 years, if they are able to produce a semen sample.

  • Protection of fertility in childhood cancer patients by later autotransplantation of cryo-preserved testicular stem cells will probably be a future option for this patient group.

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  1. Department of Dermatology and Allergology, Technical University, Biedersteiner Str. 29, 80802, Munich, Germany

    F. -M. Köhn

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Editors and Affiliations

  1. Center of Dermatology and Andrology, Justus Liebig University Giessen, Gaffystraße 14, 35385, Giessen, Germany

    Wolf-Bernhard Schill

  2. Center for Medical and Urological Andrology and Reproductive Endocrinology, University Hospital Ghent 6K12IE, De Pintelaan 185, 9000, Ghent, Belgium

    Frank Comhaire

  3. Department of Oncology, University of Edinburgh, Western General Hospital, Human Genetics Building, Edinburgh, EH4 2XU, Scotland UK

    Timothy B. Hargreave

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Köhn, F.M. (2006). Cryopreservation of Spermatozoa and Testicular Tissue Including Autotransplantation of Germinal Epithelium. In: Schill, WB., Comhaire, F., Hargreave, T.B. (eds) Andrology for the Clinician. Springer, Berlin, Heidelberg . https://doi.org/10.1007/3-540-33713-X_98

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