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Freezing or cryopreservation of the sperm is an effective, convenient and affordable way to preserve fertility in men. This method is safe, standardized, non-invasive and quicker process than the more invasive female fertility preservation process. 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. Other than that sperm preservation is also helpful in preserving fertility in men with high- risk profession, pre-vasectomy patients, and lifestyle choices (advancing age due to career). Let’s know about the new start-up for sperm preservation, why to preserve sperm, the process of preservation and the barriers of it.
Legacy- A New Start-up to Preserve your Sperm
Legacy is a new start-up to preserve your sperm. It was founded to ensure that forward looking men can store their healthiest sperm and can lock in their future. For healthy fertility in men, a high sperm count along with good motility and sperm morphology is necessary. A high amount of DNA fragmentation in the sperm cells can result in reduced fertility in men and reduced success rates of implantation. Sperm DNA fragmentation can occur due to various internal and external factors including oxidative stress, abortive apoptosis, infections and reactions to medicines, time after ejaculation, handling conditions, temperature. Legacy, the new start-up has designed a technology to make the process of sperm preservation as straightforward as possible.
A Switzerland based private Sperm Bank for freezing and analysis, “Legacy” provides the products with focus on three key values- privacy, quality and security. They have designed a straightforward technology where you don’t need to visit to clinics or meet with physicians. A simple at-home kit is dropped off and picked up by their couriers and allows to make your deposit from home. The technique involves a careful, step by step approach, to ensure that the assets are transported safely, analysed and preserved cryogenically in secure, temperature- optimized liquid nitrogen tanks and available to the belonging person indefinitely.
Why Preserve your Sperm? Legacy!
One of the most common indication for sperm preservation is Cancer especially in adolescents and young adults. Advanced diagnostic procedures and treatment of cancer have significantly increased the survival rates of these patients. But in these patients the quality of semen is poor due to multiple factors causing infertility or unhealthy sperms. Cancer chemotherapy negatively affects spermatogenesis (sperm formation), and directly damage proliferating cells and sperm precursors, transiently or permanently. Although improved chemotherapy regimens have resulted in lower rates of infertility, but significantly reduced sperm counts after treatment continue to be a concern. Radiation therapy adversely affects the semen quality by damaging DNA. Surgical procedures in cases of testicular cancer can also cause infertility. Therefore, all the cancer treatment regimens adversely affect the fertility potential. So, in these patients sperm preservation plays a vital role in future for fertility.
A study was done by Buck Louis GM et al. and published in the journal of Fertility and Sterility, May 2014. The study was done to assess the effects of environmental chemicals phthalates and urinary bisphenol A on couple fecundity. Phthalates are chemicals that make the plastics flexible and lotions easier to apply. Also, this chemical is present in common household products, detergents, textiles and cosmetics. The study found that phthalates levels adversely impacted fertility in men causing approximately 20 percent reduction in fecundity. So, the various environmental factors and advancing age make the preservation of sperm very important.
Process of Sperm Preservation
The process of sperm preservation includes semen collection and its cryopreservation or freezing. Prior to cryopreservation, semen analysis is performed for all samples. Semen parameters are documented in accordance with the WHO guidelines. Sometimes multiple collections are recommended depending on the number of motile sperm in the semen, the time since the last ejaculation, and individual variability.
Semen for sperm cryopreservation is generally obtained by masturbation. This method may be an embarrassing or uncomfortable process for many men, but it is critical that men understand how to collect the semen. Men should be offered a private and relaxing environment to do so. Alternatively, they may collect a semen sample at home (at-home kits are available eg. Legacy) or another location than the clinic. In this, they should keep the semen specimen at body temperature and return it to the lab within approximately 45 minutes to 1 hour after collection. One should avoid lubricants as they can contaminate the semen specimens. As more sperm are present at the beginning of the ejaculate than at the end, one must keep this in mind while collecting the semen sample. Wide-mouth specimen containers tested by laboratory are compatible with semen collection and are not harmful to sperm.
Some men can have difficulty in providing semen specimens with masturbation. So, an alternative to it is to collect the sample with a condom. As commercially available condoms generally contain spermicides that kill sperm, so the condom must be approved by the laboratory. Although this method typically results in fewer sperm being collected but it may be necessary for some men. In addition, anxiety, religious beliefs, pain, medications, and other factors may make semen collection challenging in some persons. In the adolescent male population, extremely careful counselling and age-appropriate instructions are necessary, as these patients are at risk for emotional distress from this process. Some men or cancer patients are quite ill and debilitated at the time of presentation and are unable to produce a sample. In these cases, surgical sperm retrieval can be offered and is helpful.
In sperm preservation and banking, sperm are kept in vials with cryoprotective agents such as glycerol in combination with test yolk buffer. These vials can be stored indefinitely in liquid nitrogen. Although paternity with cryopreserved sperm is clearly possible, but the freeze–thaw process may either negatively affect sperm quality and/or enhance any underlying sperm defects. So, the number of specimens that should be cryopreserved will differ for each patient. The determining factors include age, number of previous children, and semen quality. Future techniques of dry storage may afford less damage to sperm. When semen is cryopreserved, a small aliquot is frozen separately, thawed, and reanalyzed after the initial freeze. This ‘test thaw’ allows determination of the postthaw survival, as it can vary among individuals and even among different ejaculates from the same person.
Barriers to Sperm Preservation
Modesty of both the patient and healthcare provider, privacy, discomfort, cost, urgency to begin treatment, and access to sperm banking facilities are some of the various reasons a person may not choose to preserve semen. The most common reason is because of the lack of information. Finding a sperm bank should not be a barrier in discussing the option. Legacy is a Swiss private sperm bank offering sperm cryopreservation with straightforward technology. Most banks have mail kits available that allow patients to collect sample at home and ship them to the sperm bank. This approach allows both privacy and convenience for the patient.
There may be legal considerations surrounding sperm banking. As summarized by Leonard et al. the law surrounding cryopreservation of semen is still uncertain. It remains unclear whether semen is categorized as property, person, or a unique material that is neither person nor property. Sperm banking also raise ethical issues such as whether sperm donation should be anonymous or sperm can be utilized posthumously by the surviving partner without consent from the patient.
To preserve male fertility and to continue the legacy, men should consider cryopreservation of semen. Sperm banks are available in helping to do so. Especially young cancer patients must know this option, so that they can enjoy parenthood later in their life. All healthcare providers should give information regarding this option and sperm banking to the general people so that everyone can take advantage of it. There are a lot of competitors to sperm preservation startups like Legacy.