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Emerging trends of various types of cancer in young people as well as in old, increase in the number of new cancer cases and all cancer therapies—chemotherapy, radiation, and surgery—are potential threats to a man’s reproductive potential. Cancer survival rates have improved dramatically over the last couple of decades due to advanced diagnostic techniques and therapies. For many men and their families, the maintenance and preservation of fertility during and after treatment is important. Nowadays unmarried women and lesbian couples have almost unlimited freedom to decide whether to have children and to select the most desirable genetic material. Sperm preservation banks offer hundreds of donors of different outward appearances, personality traits, and ethnic origins. Hypothetically, conceiving of a sperm donation without any male involvement could potentially have a liberating effect on women. So, the sperm preservation is important and is the future.
Sperm Preservation as the Future
Sperm preservation or sperm freezing is principally used to store sperm to preserve fertility in men undergoing cancer therapy and allow conception for infertile couples. The scope of clinical indications for sperm freezing has expanded widely over recent years. So, more patient groups are eligible for sperm freezing, requiring specialist resources. Anticancer medicines, radiation therapy, and surgical therapies can all pose significant threats to a man’s fertility potential, as can the presence of cancer itself. Infertility in men due to cancer treatments may be temporary or permanent. It can range from mild to severe. It is very difficult to predict the exact impact of cancer therapy on an individual man’s ability to father a biological child, so sperm freezing prior to therapy remains the cornerstone of fertility preservation in this patient population.
There are many other conditions where preserving the sperm plays a pivotal role in the parenthood. Many men spend a lot of time away from their spouse due to profession or other reasons. Apart from that due to lifestyle changes both the quality and quantity of sperm deteriorates with advancing age and that too it might start in young age. So preservation of the sperm becomes crucial to enjoy parenthood in future or later in the life.
Benefits of Sperm Preservation
Many men choose to preserve their sperm to ensure that they can father healthy babies later in their life. There are many reasons of choosing this wonderful method. Such as:
- Deteriorating sperm quality and quantity
- Medical issues like Cancer etc
- Advancing age
- Pre-vasectomy Patients
- Career and Lifestyle Choices (High-risk occupations)
- People undergoing a sex-change operation
Cryopreservation of the sperm is an effective, convenient and affordable way to preserve fertility in men. This method is safe and standardized and also it is non-invasive and quicker process than the more invasive than the female fertility preservation process.
Attitudes about Sperm Preservation
More than half of the cancer patients desire future fertility, including over three quarters of those without children at the time of their cancer diagnosis. Currently, sperm freezing and banking is the only pre-treatment strategy for male cancer patients to preserve their future fertility. However, less than one fourth of cancer patients preserve sperm, and the most common reason for not doing so is lack of information.
According to a study done by Reebals et al., they addressed oncology nurse practice issues in determining whether newly diagnosed adolescent male patients are offered the option of sperm banking before undergoing chemotherapy treatment. They distributed questionnaires to nurses and nurse practitioners who care for adolescent male cancer patients at the time of diagnosis, during chemotherapy, and during follow-up care. Over 95% of respondents agreed that all male patients undergoing cancer treatment should be offered sperm banking.
Oncologists and nurse practitioners are the appropriate professionals to discuss this option. Another study by Saito et al. reported a positive psychological effect in 80% of interviewed cancer patients who preserved sperm. They also found that, if sperm was banked on the patient’s own initiative, that doing so offered encouragement during therapy.
Sperm Preservation in Adolescent Males
Adult male cancer patients may be more willing to accept the notion of sperm banking to preserve their future fertility, but adolescents may be intimidated and embarrassed by this concept. The fertility wishes of adolescents may not be realized for many years, and the long-term psychosocial impact of infertility on survivors of childhood cancer remain largely unknown. Also, the opinions vary regarding the most appropriate age for discussing sperm freezing and banking.
A study was done by Ginsberg et al. for examining the feasibility of offering sperm banking to young male cancer patients and determining the beliefs and decision-making processes of these patients and their parents. They found that 80% of the patients made the decision to bank sperm with their parents. All of the patients who banked sperm felt that they were making the right decision to do so. Patients and parents alike wanted information about semen freezing (cryopreservation). They concluded that because semen quality was dramatically reduced, even by one course of gonadotoxic (deleterious effects on gonads) therapy, that sperm banking should be offered to all eligible patients prior to therapy. Parents of the adolescent cancer patients played an important role in the decision to bank sperm.
Another important concept is emotional maturity, when discussing sperm banking in adolescent males. Boys who are not physically mature may still be able to collect semen (sperm). Conversely, a physically mature adolescent may not be emotionally or sexually mature to perform a semen collection by masturbation.
Future Avenues for Sperm Preservation
During puberty, mature sperm begin to appear in the ejaculate semen. Sperm suitable for preservation can be collected in any boy with pubertal development. But a recent study done on 12–17 year old boys suggested that cryo-preservation was most feasible in those older than 13 years. Survival rates of childhood cancer are also increasing, so it is important to investigate whether fertility preservation is possible in prepubescent boys with cancer. Spermatogonial stem cells or testicular tissue may be cryopreserved by slow freezing using 1.5 M dimethylsulphoxide and 0.15 M sucrose as cryoprotectants. The research investigating the cryopreservation of spermatogonial stem cells or testicular tissue to restore fertility is ongoing. Spermatogonial stem cells can also be successfully cultured in vitro without losing their stem cell properties.
Sperm freezing and banking is an established and effective mode of preserving fertility in at-risk patients and for treating couples who would otherwise be unable to conceive. While cancer is the most common indication for fertility preservation, many conditions, risk factors and treatments having the potential to impair sperm function requires all healthcare providers to enquire about the reproductive wish of their patients, with minimum potential negative effects on fertility. Perhaps the biggest challenge to sperm freezing and banking is the ever-expanding list of indications in which it has become incorporated. Regulations for sperm banking were formulated historically to treat men with cancer or heterosexual couples with infertility but the clinical landscape of sperm banking has already changed dramatically, which is illustrated by the increasing utilization of cryopreservation by homosexual and transgender couples.