Freezing sperm to save them for future children

There's an equal chance that difficulty in conceiving a child is due to issues with the man or woman in a couple. — 123rf.com

Fertility is a personal matter and parenthood is a choice.

Some don’t want or can’t have children, while others plan meticulously for the right moment to conceive, only to realise that their biological system also has a mind of its own.

The difficulty and inability in conceiving a child affects many couples, leading to anxiety and emotional distress.

While it is commonly misconceived that infertility is predominantly a female issue, in reality, infertility can affect anyone, regardless of gender or age.

The ratio is typically 50:50 between the man and the woman in the couple.

The World Health Organization (WHO) estimates that 17.5% of people across the globe have experienced infertility at some point in their adult lives.

Age, stress, environmental factors, smoking and being significantly over- or underweight are known to have the biggest impact on fertility and the chances of conception.

Although fertility rates are decreasing, there are many types of assisted reproductive technologies (ARTs) available for couples wanting to get pregnant.

One of them is fertility preservation, i.e. the process of freezing eggs, sperm or other reproductive tissues in the hopes of conceiving at a later date.

Tick-tock goes the clock

Men have a biological clock too.

While their fertility decline happens more gradually, studies show that ageing can affect semen volume and sperm quality in terms of motility (movement) and genetic abnormalities.

One study reviewing over 40 years of research on male fertility in the United States found that men aged 45 and above are at a higher risk of having babies with heart abnormalities, facial deformities and chromosome disorders.

Older fathers may also increase their partners’ risk of developing pregnancy complications.

On the local front, it was found that 60% of the sperm analysis tests conducted by the National Population and Family Development Board between 2010 and 2019, exhibited abnormal results.

And based on all ART procedures performed, three-quarters were carried out for male fertility problems, with an encouraging fertilisation rate of 80%.

Consultant obstetrician and gynaecologist, and fertility specialist, Dr Eeson Sinthamoney emphasises the importance of addressing this critical aspect of men’s reproductive health.

“Is male infertility on the rise?

“The answer is a resounding yes, and its impact is undeniably real.

“As societal and environmental factors continue to evolve, we are witnessing a steady increase in the prevalence of male infertility cases.

“It is crucial that we recognise and tackle this issue head-on by providing comprehensive support and tailored solutions to individuals and couples navigating the challenges of infertility,” he says.

Male infertility can be attributed to various biological factors, including genetic abnormalities, hormonal imbalances, anatomical issues, underlying medical conditions and lifestyle choices such as smoking, excessive alcohol consumption and poor diet.

Says Dr Eeson: “While body weight does not primarily affect infertility in men, lifestyle choices like engaging in frequent and long bicycle rides can have an impact.

“A simple sperm test serves as the initial step in assessing sperm count and overall fertility health.”

Genetic testing to identify any abnormalities that may contribute to infertility, can also play a crucial role in the diagnosis and management of severe male infertility.

Cryopreservation is particularly beneficial for men who are undergoing treatment that may impact their fertility, such as chemotherapy or radiation therapy.

The men first undergo a health screening to ensure they’re free from any infectious diseases.

They are then given a plastic cup or bottle, and provided a private room to produce their semen sample.

The sample is then analysed to assess the health and quantity of sperm available for freezing, before being put into a special freezing solution.

Finally, the prepared samples are stored in freezers that contain liquid nitrogen to preserve the sperm, which can be stored indefinitely without any ill effects.

As a precaution

Motion designer Kamal (not his real name), 33, has frozen his sperms in the hopes of having more children in future.

There are a number of causes of male infertility, which need to be properly investigated and diagnosed before they can be treated. — Positive Parenting

In March (2023), the father of one discovered that one of his testicles was hard and increasing in size.

Worried, he went for a check-up, and the doctor recommended he do an orchiectomy (a surgical procedure to remove one or both testicles) and a biopsy.

Kamal then sought second and third opinions – everyone suggested the same thing, so he opted for the surgery.

“Prior to that, the urologist who treated me explained that if the biopsy results showed cancer, then he will check how severe it is and if the cells have metastasised.

“And that I might need to undergo chemotherapy, which will affect the sperm quality.

“Therefore, he advised me to look into sperm banking if we want to have another child,” he says.

The biopsy revealed it was indeed testicular cancer, but fortunately, the cancer cells had not metastasised.

Kamal recalls: “The urologist sent me to the oncologist who told me that although my cancer cells were removed and I was ‘all clear’, my case was in the grey area and he wasn’t sure if I needed chemotherapy.

“Thus, he advised me to monitor my condition every three months because he did not want to overtreat me with chemotherapy.

“But just in case, we did the sperm cryopreservation after that.”

Kamal did not feel uncomfortable collecting his sperm as he had done a sperm test before and the process was similar.

“It’s like an obligation to do this to plan for another child, although the doctor suggested that I do the ‘procedure’ two or three times because my sperm quality was not as expected,” he says.

He plans to cryopreserve his sperms for the next two or three years (and have another kid) as storage is expensive.

He says: “I am currently under surveillance.

“I am lucky that my testicular cancer was at stage one, hence everything was removed.

“Now I will need to have my tumour marker blood tests every three months and a CT (computed tomography) scan after a year.”

Getting emotional support

Cycling too long and too often can have an impact on a man's fertility. — Filepic

Seeking emotional support is a crucial aspect of navigating the challenges of male infertility.

Counselling and therapy will provide a safe space for men or their partners to express their emotions, share experiences and gain valuable insights into coping strategies.

Managing stress and adopting healthy coping mechanisms can help alleviate the emotional burden.

Techniques such as mindfulness, relaxation exercises, and engaging in hobbies or physical activities, can provide much- needed respite and promote overall well-being.

“While the topic of infertility has gained significant attention in recent years, the focus has often centred around women’s experiences.

“However, it is equally crucial to understand men’s perceptions towards infertility and how it impacts their emotional well-being, relationships and overall quality of life,” says Dr Eeson.

He highlights that the landscape of fertility and conception has significantly changed over the past 30 years.

Couples now tend to opt for smaller families with one or two children, compared to previous generations’ preference for four to five children.

Men are now also more open to seeking consultations, providing sperm samples and exploring the next steps in their fertility treatment.

“To all men facing infertility, there is no need to feel shy or embarrassed.

“Embrace the transformative journey towards parenthood, as numerous possibilities exist for starting a family,” he says.

While the decision to freeze one’s sperm or eggs is a highly personal one, it’s worth thinking about future-proofing your fertility regardless of whether you’re single or partnered.

“Fertility preservation methods can’t offer a guarantee, but they can definitely increase your odds at conceiving.

“In that sense, it can help with easing the stress of ‘when’ you should have children, and give you some breathing room in making the right choice for your circumstances,” says consultant obstetrician and gynaecologist, and fertility specialist, Dr Aldrin Lie.

As for the health of infants born from frozen sperms and eggs, research has indicated that there is no significant difference between babies from fresh or frozen sperms and eggs.

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