COSA:AYA cancer fertility preservation/Options for fertility preservation/Cryopreservation of epididymal or testicular extracted sperm

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Fertility preservation for AYAs diagnosed with cancer: Guidance for health professionals. > COSA:AYA cancer fertility preservation/Options for fertility preservation/Cryopreservation of epididymal or testicular extracted sperm

Cryopreservation of epididymal or testicular extracted sperm

When it is not possible to obtain an ejaculate, or when the semen contains no sperm because of previous damage to spermatogenesis or obstruction of the vas deferens, it may be possible to obtain sperm by direct testicular or epididymal aspiration or biopsy.[1] Sperm suitable for use in ICSI may also be extracted from orchidectomy specimens from males with testicular cancer.[2]

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Risks and side effects

There is no evidence that a history of treated cancer increases the rate of congenital abnormalities or cancer in a man’s children.[3][4][5] Higher rates of sperm aneuploidy have been reported to occur for up to 18 months after chemotherapy and radiotherapy.[6]

Freeze thawing of sperm in non-cancer patients has not been associated with any increased risk of adverse outcomes in assisted reproduction treatments. However overall, assisted reproduction (both IVF and ICSI) is associated with a slightly increased risk – 6.4 per 100 births, compared to 4.8 per 100 births from unassisted conception, which equates to one extra birth defect for every 62 births.[7]

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Depends on treatment centre.

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  1. Shin D, Lo KC, Lipshultz LI. Treatment options for the infertile male with cancer. J Natl Cancer Inst Monogr 2005;(34):48-50 Abstract available at
  2. Carmignani L, Gadda F, Gazzano G, Ragni G, Paffoni A, Rocco F, et al. Testicular sperm extraction in cancerous testicle in patients with azoospermia: a case report. Hum Reprod 2007 Apr;22(4):1068-72 Abstract available at
  3. Blatt J. Pregnancy outcome in long-term survivors of childhood cancer. Med Pediatr Oncol 1999 Jul;33(1):29-33 Abstract available at
  4. Meistrich ML, Byrne J. Genetic disease in offspring of long-term survivors of childhood and adolescent cancer treated with potentially mutagenic therapies. Am J Hum Genet 2002 Apr;70(4):1069-71 Abstract available at
  5. Winther JF, Boice JD Jr, Mulvihill JJ, Stovall M, Frederiksen K, Tawn EJ, et al. Chromosomal abnormalities among offspring of childhood-cancer survivors in Denmark: a population-based study. Am J Hum Genet 2004 Jun;74(6):1282-5 Abstract available at
  6. Tempest HG, Ko E, Chan P, Robaire B, Rademaker A, Martin RH. Sperm aneuploidy frequencies analysed before and after chemotherapy in testicular cancer and Hodgkin's lymphoma patients. Hum Reprod 2008 Feb;23(2):251-8 Abstract available at
  7. Halliday JL, Ukoumunne OC, Baker HW, Breheny S, Jaques AM, Garrett C, et al. Increased risk of blastogenesis birth defects, arising in the first 4 weeks of pregnancy, after assisted reproductive technologies. Hum Reprod 2010 Jan;25(1):59-65 Abstract available at

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