In this article, we explain the benefits of sperm freezing and describe how this form of fertility preservation works in Switzerland.
It is well known that female fertility decreases with age. But what about the fertility of men over the age of 35? Are there reasons that men should also think about preserving their fertility?
In this article, we explain the benefits of sperm freezing and describe how this form of fertility preservation works in Switzerland.
What is Sperm Freezing?
Sperm freezing is a reproductive medicine procedure in which sperm are frozen for possible future family planning. When it comes to sperm freezing, a distinction is made between social freezing and medical freezing.
Sperm collection and freezing is done in the same way with social and medical freezing. The main differences are reflected in the reasoning, and legal and financial aspects (as medical freezing is often covered by health insurance companies).
| Social Freezing | Medical Freezing | |
|---|---|---|
| Reasoning | Freezing for social reasons, such as wanting to have the freedom to prioritise their career or waiting to find the right partner. | Freezing for medical reasons, like testicular cancer, undergoing cancer treatments (chemotherapy or radiotherapy), or surgery on prostate or testicles. | Cost | Not covered by Swiss health insurance and must therefore be borne in full by the private individual. | Covered by Swiss health insurance for men up to the age of 40 for sperm freezing if there is a more than 20 percent that they may end up with azoospermia (complete absence of sperm in the ejaculate). |
| Legal | Sperm may be frozen and then used within a maximum of 10 years. | Sperm may be frozen and stored for beyond 10 years with authority approvials. Thawing and using the cryopreserved sperm can only be done if it is proven that the patient can have a good quality of life. |
In Switzerland, the usage of frozen sperm also differs between social and medical freezing. In the latter case, thawing and using the cryopreserved sperm can only be done if it is proven that the patient can have a good quality of life. This means that if they have a malignant disease (one that gets progressively worse), there must be a reasonable belief that they will still have a normal life expectancy.
Why do some men freeze their sperm?
There are several reasons why men have their sperm frozen without medical indication:
Age: Like female fertility, male fertility also decreases with age. It is half as high in men over 35 years of age than in men over 25 years of age. It continues to decrease more rapidly towards their 70s or 80s. Much more important for family planning is the fact that sperm quality decreases with age. Increased paternal age is associated with a higher rate of miscarriage, hereditary occurrences of ADHD and schizophrenia, premature birth, and preeclampsia in women.
Inability to be present during assisted insemination procedure: Assisted reproductive techniques, like IVF, require the man's ejaculate at a specific point in time. For this, a man usually goes to the fertility center and masturbates there to provide a fresh semen sample. However, if this is not possible due to scheduling reasons (e.g. because the man has to travel on business on the day of the artificial insemination), he can provide a sperm sample in advance and have it frozen.
Dangerous Occupations: Certain occupations carry a high risk for male infertility. Males who are occupationally exposed to radiation or toxins may also consider social freezing. In some countries, even soldiers have sperm frozen so that if they die in the war, their wives can father a child post mortem. In Switzerland, no germ cells from deceased partners may be used for artificial insemination. You can read more about this in our article on the legal basis of artificial insemination in Switzerland.
Sperm Donation: Men who donate their sperm also go through the sperm freezing process, as their sperm are cryopreserved until perhaps chosen by a couple. Their sperm samples can be stored in a sperm bank. According to the Swiss Reproductive Medicine Act, frozen donor sperm may remain in long-term storage for five years, with potential to extend the deadline to ten years.
How does sperm freezing work?
- Preliminary clarification: If you want to have sperm cells removed and frozen, you first go to a fertility center. There, your medical history will be taken and the procedure explained. You will also have a blood test for any infectious diseases, such as HIV or hepatitis C.
- Sperm provision: Unlike women, who have to first go through hormone therapy and then have eggs surgically removed, men typically only need to provide a sperm sample. This is usually done at the fertility clinic through masturbation. There are also men who prefer to masturbate at home and then hand in the sample to the clinic. However, you need a special container for this, and you have to hand in the sample to the clinic immediately afterwards.
If a man suffers from anejaculation, i.e. he has no ejaculation despite having an orgasm, a process called electroejaculation may be used to get the sperm. During electroejaculation, various nerves that are responsible for ejaculation are stimulated and thus produce an ejaculation. Another issue can be that a male can ejaculate, but has an extremely low sperm count or there is no sperm in the semen sample (called azoospermia). In this case, the surgical removal of testicular tissue (TESE) for sperm collection is possible.
- Sperm analysis & sperm processing: Performed in a laboratory, a semen analysis considers many factors of ejaculate, including semen quality, sperm count, sperm morphology and sperm motility. These influence how likely it is that sperm can fertilise an egg. The sperm are processed, meaning that the most mobile and qualitatively best sperm are separated from the other substances in semen. The remaining sperm are then placed in a vial.
- Freezing & Storage: Now the sperm are frozen in liquid nitrogen, usually at -196 degrees Celsius, and stored in special containers. The containers are placed in the so-called cryobank until they are fertilised. After ten years, the germ cells must be disposed of properly. In the case of cancer patients, the deadline may be extended.
What happens after the thawing process?
If a couple chooses sperm from a sperm donor, or fails to conceive naturally, the frozen sperm are thawed. The functional sperm are then used in fertilisation by assisted reproductive technology (ART).
If there are a great number of high quality sperm, a sample may be used for intrauterine insemination (IUI), where sperm is injected directly into the uterus. In most cases, the thawed sperm will be used in intracytoplasmic sperm injection (ICSI), which is a form of in vitro fertilisation (IVF). You can find more information about the process of ICSI and IVF in our article.
How much does freezing sperm cost in Switzerland?
The cost of sperm freezing varies depending on the fertility clinic. Patients can expect costs of between CHF 500 and CHF 1,500 for the procedure up to freezing and annual costs of between CHF 200 and CHF 500 for storing the sperm in the cryobank. If the patient requires additional services, such as electroejaculation, testicular sperm extraction (TESE) or genetic testing, the price will be adjusted upward. It is also important that you are aware that after thawing, there will be further costs for the assisted reproductive technology.
How can I support the process?
There are numerous measures you can take to improve your own fertility. First and foremost, you should aim to freeze your sperm before the age of 40. If you are over that age, visit a fertility clinic to find out your options.
You can also opt for a number of lifestyle changes, including:
- A healthy and balanced diet
- Regular physical activity
- Maintaining a body mass index <25 and >18.5
- Reduction of as many stress factors as possible
- Avoidance of cigarettes and alcohol
- Getting enough sleep.
See our article on sperm count for more detailed information on male fertility. Please note, however, that the quality of the egg cells and the general state of health of your partner also have an influence on the success of subsequent fertilisation.
What else is there to consider?
There is debate among experts about the benefits of cryopreservation for men. As explained at the beginning, the quality of the sperm decreases with advancing age, and certain diseases can be traced back to the increased age of the father.
Previous research results further show that cryopreservation can also have negative effects on sperm or even damage them. However, this has no significant impact on the chances of successful conception. This was shown by a study in which the fertilisation rate, embryo quality and pregnancy rate of thawed and fresh sperm in ICSI treatments were compared. In principle, we recommend that you check with your fertility specialist in advance whether the age-related risks outweigh the genetic risks of cryopreservation.
The same should be considered before a vasectomy (a surgical procedure that prevents sperm from mixing with semen and being ejaculated). Some doctors recommend that their patients freeze their sperm before undergoing this procedure. An international study involving 228 urologists from six European countries has shown that there is no uniform consensus when it comes to recommending conservation of sperm before a vasectomy.
It should also be noted that neither social freezing nor any assisted reproductive technology can guarantee that the desire to have children will be fulfilled. In general, it is best to get several opinions and to inform yourself about the possible risks and side effects of cryopreservation.
Frequently asked Questions
Up to what age is sperm freezing possible?
The medical literature reports an increasingly significant decrease in sperm quality after the age of 35, with the benefits of sperm freezing being greatest before the age of 40. Accordingly, the sperm should—if possible—be frozen beforehand. However, there is no legal age limit for sperm freezing. Some clinics set their own maximum age. It is therefore best to find out more directly from the clinic of your choice.
Do I have to take a day off for the process?
No. In general, your appointment for providing a sperm sample will take around 30 minutes or less. If you have other concerns about the timing required, feel free to ask your fertility specialist.
Can I deduct sperm freezing from my taxes?
Social sperm freezing costs are not tax deductible. For cancer patients, the costs for medical freezing are often covered.
Does sperm freezing have any side effects?
No, there are no side effects for men. However, the delivery of the sperm sample is uncomfortable for some, because it requires masturbation in the fertility clinic. If you are uncomfortable with providing a sperm sample or are feeling nervous about the process, it is a good idea to talk to your fertility specialist. They can assure you that the process is common and provide suggestions for how to make it easier.
Takeaway
Social sperm freezing is one way to preserve male fertility and take control of your family planning. Although the body of literature on the influence of paternal age on the health of offspring is not as comprehensive as that on the age of mothers, it is nevertheless clear that the father's age should be taken into account when planning a family.
The procedure of cryopreservation may impact sperm parameters. However, research is relatively unclear, with at least one study showing that the process does not significantly impact conception. Despite this, men who consider social sperm freezing at a later date due to possible family planning must weigh the genetic risks of older age and those of the procedure itself with the help of a medical professional.
Are you interested in freezing your sperm or would you like to know how your fertility is doing? Our empathetic specialists are at your disposal. Reserve your spot for a free consultation today.
