Cryopreservation of sperm
For men, the cryopreservation of sperm is a well-established procedure.
Before the cytotoxic therapy, one or several sperm samples can be obtained by masturbation. The preservation also makes sense when the sperm quality is poor. If the cryopreserved sperm is to be used at a later stage, there is a choice between the relatively simple intrauterine insemination or ICSI treatment depending on sperm quality and quantity.
The prophylactic cryopreservation of sperm prior to cytotoxic therapy can always be recommended since, if all available techniques are used, even men with very limited sperm quantity or quality will have a subsequent therapy option whose chances mainly depend on other prognostic factors such as the age of their partners.
Cryopreservation of testicular tissue
In some cases, there is azoospermia although the testicular tissue still produces sperm. This may be caused by obstructed seminal ducts or retrograde ejaculation. There may also not be enough time to obtain sperm before an operation on the testes, e.g. for testicular cancer. In these cases, it is possible to freeze and store testicular tissue in a centre for reproductive medicine.
However, this requires some logistical preparation (the patient must be informed about costs, arrangements must be made with the laboratory etc.), so that it is not normally possible to preserve the tissue spontaneously during testicular surgery. If the tissue is to be used for when the couple wishes to have children at a later stage, ovarian stimulation of the partner and ICSI treatment is necessary due to the low sperm count in the testicular tissue. The success rates depend among other factors on sperm quality but also on the age of the partner.