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Clients Freezing and Storing Semen: Cryopreservation

SUCCESS RATE WITH FROZEN SEMEN

Future reproductive options for the use of cryopreserved sperm include intrauterine insemination (IUI) or in vitro fertilization (IVF). The average conception rate for the first option, IUI, is 4-10% per cycle. With samples exhibiting lower than average fresh semen parameters, the conception rate may be lower. The latter option, IVF, would be reserved for situations where the initial sperm parameters are less than ideal, where the freeze/thaw process results in poor sperm characteristics (as determined by the test thaw), or where very few frozen sperm samples are available. In general, IVF with cryopreserved semen does not per se reduce the success rate of IVF. We recommend that patients discuss the optimal use of their frozen samples with a specialist in reproductive medicine at the appropriate time in order to maximize their chances for achieving a pregnancy.  Problems such as miscarriage, implantation in the fallopian tube, and birth defects are possible in any pregnancy.  There is no increased risk of any of these problems associated with the use of cryopreserved semen.
 

THE SEMEN CRYOPRESERVATION PROCESS

Variability in the success of the freezing process occurs between individuals as well as between semen samples. For each semen sample we determine the semen volume, sperm count (concentration), and percent motility. The sample is diluted with cryoprotectant to protect the sperm from freezing conditions and distributed into cryovials. Each semen sample will yield one or more vials, the volume per vial (up to 1.8 ml) and the number of vials being determined by the volume and quality of the sample. Each vial is labeled with the patient’s name, the freeze date, and the vial number. The vials are slowly cooled, then frozen and stored at a recorded, unique location in our liquid nitrogen tanks. Generally, following freezing of the first sample, a small volume of semen is thawed to determine the success of the freezing process and the number of motile sperm per vial. Initial and post-thaw sperm counts and motilities are usually not done on samples received subsequent to the first sample.
 

THE NUMBER OF SEMEN SAMPLES TO FREEZE 

Based upon knowledge of semen quality, conception rates, current technology, anticipated sample need, and time constraints, the patient, with the advice of his physician, must decide how many samples to freeze. Please be mindful that sperm cryopreservation does not guarantee future reproductive success no matter how many samples are frozen.  The goal is to preserve a reasonable chance at producing a pregnancy.

The Andrology/Embryology Laboratory recommends that sufficient sperm samples be cryobanked to provide thawed sperm for at least 4 intrauterine inseminations containing at least 10-20 million motile sperm each.  The number of samples needed to achieve this is entirely dependent on the sperm count and motility of each ejaculate.  For example, individuals with normal sperm parameters may satisfy this level by freezing 2 semen samples.  Individuals with less than optimal sperm parameters may prudently freeze several samples. Samples less than optimal for IUI may effectively be used in IVF. It is understood that some patients may not have sufficient time to freeze multiple samples before undergoing their medical treatments. The Laboratory will provide the cryopreservation data to the patient’s physician and will indicate whether additional freezing is recommended. Such a recommendation should not be considered a requirement. The Laboratory does not have a comprehensive history of the patient’s needs or future desires, so the recommendation is simply based on the semen parameters and the number of samples previously frozen.  Regardless of the number of samples cryopreserved, the options for their use should be carefully considered when the patient is ready to consider attempting a pregnancy.
 

LENGTH OF TIME SEMEN SAMPLES MAY BE FROZEN

Theoretically, the viability of cryopreserved semen may be maintained indefinitely because it is stored in a liquid nitrogen freezer at a temperature of -196o C.  Pregnancies have been reported from samples stored over 20 years.
 

SCHEDULING APPOINTMENTS

Appointments to cryopreserve semen are scheduled Monday through Friday from 7:30 a.m. to 12:30 p.m.  Two to three days of sexual abstinence is recommended before each appointment.  Optimally, samples are collected in one of the private rooms next to the lab, or alternatively, may be collected elsewhere and brought in.  Samples should be collected in a sterile Andrology Lab collection container or in a special condom provided by the Andrology Lab for a nominal charge.  Samples collected elsewhere should be brought to the Andrology Lab within one hour of collection and kept at body temperature during transport to the Andrology Lab.  The first appointment will take about one hour; successive appointments, less time.
 

REQUISITION

A requisition (order) for sperm cryopreservation provided by the patient’s physician is required before the initial appointment can be made. Requisitions may be FAXED to the Andrology Lab at 503-418-3708, or mailed. The Andrology Lab will FAX/mail the cryopreservation results to the requesting physician. 
 

CONSENT FOR THE USE OF CRYOPRESERVED SEMEN

Cryopreserved sperm is the property of the individual who produced the specimen(s) regardless of his marital status.  Any use of these samples for reproductive purposes is at the sole discretion of this individual. We require users to sign a consent that provides us and the individual with the "written consent" needed for their use. This includes intrauterine insemination of, or IVF with, his female partner or designated recipient. This also applies to the posthumous use of the samples.  If this consent is not signed then control over the disposition of frozen sperm samples does not automatically transfer to a spouse, partner, or to relatives in the unfortunate circumstance that the patient who provided the samples is deceased. This consent addresses  these options and provides clear written documentation from the patient attesting to his wishes under these circumstances. Please contact the Andrology Lab  503-418-3790 for further information regarding consents for the use of cryopreserved sperm.
 

FEES FOR CRYOPRESERVATION OF SEMEN

COST TO FREEZE EACH SAMPLE
Preservation of the first sample;
includes a one time post-thaw analysis.

$ 100*
YEARLY SAMPLE STORAGE  $ 250*
WITHDRAWAL FEE $   30 
The fees marked with an ( * ) asterisk
are payable on the first visit if the sample is frozen
($ 350)


Subsequent years of Sample Storage will be requested from you in writing on the Storage Renewal Form and payable in advance.  Annual rates apply for each year or any portion of a year and are non-refundable.



ONCOFERTILITY

Information in this section is intended to help physicians preserve a male cancer patient's fertility status. We appreciate there may be only a short and immediate period of time to collect semen for banking. Most patients will only to be able to bank one semen specimen. For future consideration, it is important to understand that one frozen/thawed specimen will usually provide enough sperm for several in-vitro fertilization procedures but not enough sperm for a single intrauterine insemination attempt. Also, the longer the patient is on some type of therapy the more likely it will lower his sperm production.
To help us prioratize the scheduling of your patient please have him or a family member register him as an OHSU patient by calling 504 494-8505.
Since the preparation and freezing process requires 4.5 hours to complete, we must have the semen delivered no later than 12:00. We do not freeze semen on the weekend. To best facilitate the process please print and refer to the following PDF files:
  • Semen Collection & Delivery  Information on who to call and how to collect and deliver the semen specimen. Either OHSU staff or a family member will need to deliver the specimen to the laboratory since our staff are rarely able to leave the laboratory.
  • Andrology Laboratory Physician Request  This laboratory request form is pre-set to order the appropriate semen banking option.  Just fill in the appropriate lines and Fax it in.
  • Sperm Cryo Consent.  This consent (described above) is required and must be signed by the patient. OHSU staff may sign as a witness.  It may accompany the specimen. 


DIRECTED SPERM DONOR PROGRAM

A directed donor is a known male who is not the partner of the recipient, (distinguished from above). Directed sperm donation falls under the FDA regulation of tissue products. To meet these regulations and our own internal policies and procedures, it is necessary to cryopreserve the semen, to test and screen the donor on the day of, or within 7 days before or after, the first donation, and to repeat the tests to provide a minimum 6 month quarantine. After the 6 month quarantine, University Fertility Consultants (UFC) reviews testing and screening results and determines whether the donor is eligible or ineligible. Under some circumstances, samples from ineligible donors may be released for use after obtaining the physician signature on an ineligibility notification form. Physicians at UFC are pleased to offer directed sperm donation as an option to their patients and will provide a written order to the OHSU Andrology Lab to begin the process.
 
I. Relevant Communicable Disease Testing and Screening
        a.    Testing is to be performed within 7 days before or after freezing the first semen sample but preferably on the same day. Testing is also to be performed to provide a minimum six month quarantine. The tests, run as a panel, include:
  • Serology
  • HIV 1&2 Antibody
  • Hepatitis B surface antigen
  • HTLV - I and II       
  • Hepatitis B core antibody - Total
  • Hepatitis C Virus Antibody           
  • RPR    (syphilis)         
  • Cytomegalovirus (CMV) Total Antibody  (See physician for interpretation of a positive result.)
  • Cytomegalovirus (CMV) Antibody - IgM  (Only required if CMV Total Antibody is positive.)   
  • Tests on Urine
  • Chlamydia trachomatis
  • N. Gonorrhoeae
If the first semen sample is frozen at OHSU, the donor will provide blood and urine for testing at that time. Donors living outside the Portland area must have their testing done at our designated laboratory, LabCorp, whose service centers nationwide may be located at www.labcorp.com. Such donors must obtain a LabCorp requisition and information from the OHSU Andrology Lab prior to being tested.

         b.    Screening
1. Physical Examination
Donors must obtain an OHSU Andrology Lab Donor Physical Examination form to give to the physician for him/her to complete. Any physician may conduct the exam. In the Portland area, Dr. Eugene Fuchs, 503-525-0071, a specialist in male fertility and advisor to the Andrology Lab donor program, performs such examinations for a moderate fee. The examination must take place on the day of, or within 7 days before or after, freezing the first semen sample.

2. Medical History Interview
The OHSU Andrology Lab will conduct a 10-15 minute interview, either in person or on the phone. The interview must take place on the day of, or within 7 days before or after, freezing the first semen sample. If the first semen sample is frozen at OHSU, the interview will take place at the time of that freeze. If not, the donor should call the Andrology Lab to schedule.

II. Cryopreservation of semen
Samples may be frozen at the OHSU Andrology Lab or at another FDA compliant laboratory if such laboratory agrees. For a discussion of the number of samples to freeze please discuss the contents of this with the managing physician.

III. Fees (for those
who are not the partner of the recipient)

First sample freeze (includes one year storage) $ 350
Processing fee for initial blood and urine tests $  50
Testing Panel at LabCorp, paid to Andrology Lab,
not bilabial to insurance
$ 400
Management Fee, payable on the day of the Interview
$ 500
Donor Eligibility Decision  (DED)
$ 500
above payable to OHSU Andrology Lab on the 1st visit $ 1800
Each additional sample freeze $ 100
Yearly storage,
payable at the beginning of each storage year
$ 250
 
Fees are subject to change without notice.

A physical exam performed by a doctor is needed to complete eligibility.
This cost is not included here since you may use your doctor or ours.

For questions and to get started with the process: Please call the OHSU Andrology Lab, 503-418-3790.


 

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