FP For men
Fertility Preservation Options in Men
Fertility preservation options available for male.
Sperm Banking (Masturbation) - Sperm Is Obtained Through Masturbation, Then Frozen At A Sperm Bank.
Sperm banking is the freezing and storage of semen at a sperm banking facility. Semen is obtained through masturbation. It is generally recommended that men collect three specimens prior to the start of chemotherapy, with 24-72 hours of abstinence before and between each collection. Patients who can collect only a single specimen, and those who have low sperm counts or sperm with poor motility, should also sperm bank as there are new reproductive techniques to fertilize eggs despite these limitations. Once the specimen is frozen, it can be stored for many years, until the patient is ready to use it.
Who Is Eligible?
Sperm banking is available for post-pubertal males. The patient has to be able to collect a specimen through masturbation. If he cannot, there are alternative, medical methods of collecting sperm.
Future Use and Success Rates
When ready to attempt pregnancy, the frozen semen specimens are thawed and a sperm analysis is done. The thawed specimen(s) is used with assisted reproductive technology procedures such as intrauterine insemination (IUI) or in vitro fertilization (IVF). Success rates vary based on age and fertility status of the female partner and on the quality of the pre-treatment specimen.
Sperm Banking (Alternative Collection Methods)-Sperm Obtained Through Testicular Extraction Or Electroejaculation Under Sedation In Individuals Who Can Not Ejaculate On Their Own
Electroejaculation is a way of stimulating a patient through the use of a mild electrical current to obtain a semen sample. First, the patient is placed under anesthesia. Then a reproductive urologist positions a rectal probe over the prostate gland. The probe emits a mild electrical current to stimulate ejaculation. Any semen obtained is transferred to a sperm bank for freezing and storage.
Who Is Eligible?
This technique can be used for post-pubertal males. It may be considered by those patients who would like to bank sperm but cannot produce a specimen through masturbation (because of illness, pain, anxiety, embarrassment, or religious or cultural prohibitions).
What Are The Potential Risks/Concerns?
These techniques involve the standard risks associated with anesthesia. To minimize risk, consider scheduling with other procedure(s) that the patient has to undergo requiring anesthesia. There are also the risks associated with an invasive procedure; to minimize risk, patient may need prophylactic antibiotics.
Future Use and Success Rates
When ready to attempt pregnancy, the frozen semen specimens are thawed and used with in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI). Success rates vary based on age and fertility status of the female partner and on the quality of the pre-treatment specimen.
Radiation Shielding Of Gonads - Use Of Shielding To Reduce The Dose Of Radiation Delivered To The Testes.
Testicular shielding involves the placement of shields over the scrotal sac to reduce testicular exposure. Clamshell-like shields are made during simulation and used each day of treatment with pelvic or inguinal radiation therapy. Intensity modulated radiation therapy (IMRT) may be used to minimize exposure in addition to or instead of shielding.
Who Is Eligible?
This procedure can be used for patients receiving pelvic or inguinal field radiation.
What Are The Potential Risks/Concerns?
Because patients may still receive some scatter radiation, they should also be offered sperm banking before treatment.
Future Use and Success Rates
Shielding reduces radiation dose to the testes by 3x-10x. The farther the shielded testicle from the edge of the target area of radiation, the greater the reduction.
Testicular Sperm Extraction - Use Of Biopsy To Obtain Individual Sperm From Testicular Tissue.
This technique involves the collection of sperm by surgical removal from the testicular tissue. The patient is sedated. A reproductive urologist removes small pieces of testicular tissue by biopsy or aspiration. The tissue is examined for the presence of mature sperm. Any sperm that are found are extracted from the tissue, collected, and transferred to a sperm bank for freezing and storage.
Who Is Eligible?
This technique can be used for post-pubertal males. It may be considered for patients who have no sperm found in the ejaculate (azoospermic).
What Are The Potential Risks/Concerns?
These techniques involve the standard risks associated with anesthesia. To minimize risk, consider scheduling with other procedure(s) that the patient has to undergo requiring anesthesia. There are also the risks associated with an invasive procedure; to minimize risk, the patient may need prophylactic antibiotics.
Future Use and Success Rates
When ready to attempt pregnancy, the frozen specimens are thawed and used with in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI). Success rates vary based on age and fertility status of the female partner, and on the quality of the pre-treatment specimen.
Nerve-Sparing Surgeries Some cancer surgeries involve the removal of lymph nodes in the abdomen (retroperitoneal lymph node dissection [RPLND]), and these surgeries can damage the nerves involved in ejaculation. While this does not cause a man to be infertile, it does mean that, when ready to attempt pregnancy, sperm has to be retrieved in other ways. Nerve-sparing RPLND techniques should be discussed with appropriate patients, especially those interested in future fertility. Patients should also be offered sperm banking before treatment.