Need of Cryo Bank
The current issues related to male and female infertility depicts the impact of environmental and physical changes due to various reasons such as diabetes and obesity, change in lifestyle and diet, use of chemical substances as preservatives, radiation, use of pesticides and insecticides in agriculture, dumping and burning of garbage leading to air, soil and water pollution, etc.
As per the 2015-16 data, it has been observed that the age group ranging from childhood to 45 years, nearly more than 1,40,000 cancer patients are diagnosed and approximately 40-80% female face possible infertility due to cancer treatment such as chemotherapy, radiotherapy, and surgery affecting both the ovary and the uterus.
Based on the number of primordial follicles present at the time of treatment and the dose of radiation received by the ovaries determines the fertility “window”. It has been reported to have 90% patient following total body irradiation and 97% female with total abdominal irradiation had developed with ovarian failures.
It is ideal to preserve male and female gametes or gonadal tissue before chemotherapy and radiotherapy for cancer treatment.
Many survivors are young and are diagnosed and treated before they have children. Cancer and its treatment can significantly affect the chance of a patient having a child in the future.
We, therefore, realize that it is important for all cancer specialists to discuss the storage of sperms and oocytes of their patients before chemotherapy and radiotherapy or surgical treatment. This cryopreservation is a major step in fertility preservation and helps cancer patients to have their biological children in the future.
Cancer and Infertility are two devastating diagnoses simultaneously affecting young men and women. Having to face both diagnoses can cause huge distress and therefore all patients will be offered an appointment to see one of our counselors if they wish to discuss fertility preservation.
Cryopreservation is a method in which the male (sperm) and female (oocyte) gametes can be preserved at a low temperature of -196°Cin Liquid Nitrogen for long periods and can be retrieved when it is needed for pregnancy planning.
- • Prasad Hospital has stored sperm and oocyte as well as an embryo for men and women planning for cancer treatment.
- • Our Fertility Preservation service for female patients started in 2004
- • We offer patient-centric Cryo freezing methods to eligible patients. We continue to work with Cancer specialists to ensure that after completing treatment, the patient can retrieve the frozen sample for pregnancy planning.
Scope of Services
How it is done
- • Simple procedure to remove a small sample of tissue from one or both testicles
- • The tissue is then looked at under a microscope to see whether the man can father a child.
- • Local anesthesia is usually adequate for a comfortable procedure. Occasionally required anesthesia is offered.
Cryopreservation of testicular tissue
- • Testicular tissue cryopreservation is an option for prepubertal patients and young men who are not able to produce semen samples before chemotherapy or radiotherapy treatment.
- • Many cancer patients have cryopreserved their testicular tissue prior to their treatment.
- • Spermatogenic recovery or pregnancies from cryopreserved testicular tissues have now been reported with successful results.
- • There are several methods in the research pipeline suggesting that preserved testicular tissue or cells even after many years can be used to restore fertility and/or produce sperm
- • It is reasonable to preserves testicular tissue for young patients who are at high risk for infertility and have no other options to preserve their fertility
Ovarian Cortical Strips
- • Who wants fertility preservation due to social obligation such as delaying Marriage, or
- • Whose reproductive potential is endangered by cancer therapy, for example in breast cancer or hematologic malignancies.
- • It can be performed on prepubertal girls at risk for embryonic ovarian failure.
Ovarian Tissue Vitrification (Cryopreservation)
- • Take a part of the ovary and store in liquid nitrogen and carry out slow freezing whilst treatment is undertaken.
- • Tissue can then be thawed and implanted near the ovarian fossa, either on the natural location or on the abdominal wall, where it starts to produce new eggs, conceding normal conception to take place through the eggs retrieved.
- • Women may attempt to ‘freeze’ eggs/oocyte for future use before they undergo treatment such as chemotherapy, which may affect their eggs.
- • Oocytes (eggs) are stimulated to develop within the ovaries by daily administration of hormone injections. Following this, the eggs are removed from the ovaries under ultrasound control.
- • The eggs removed are then frozen very rapidly using the technique of Vitrification.
- • Eggs can be stored for up to 10 years.
- • Vitrification is the most effective way of freezing human eggs with more than 90% of vitrified eggs surviving after thawing.
- • For the women below 35 years, approximately 1 out of 3 cycles of egg freezing will result in an ongoing pregnancy.
- • The number of pregnancies depends on the number of eggs stored, with each egg having approximately a 30% to 35% chance of leading to pregnancy in women under 35 years. The chance of pregnancy following egg freezing reduces as women age.
- • Oocyte Vitrification is still a relatively new technique; however, many babies have now been born after using this technique with no increase in abnormality rates in babies conceived after eggs frozen in this way.
Sperm cryopreservation or sperm freezing is a method for men to preserve their sperm and store it in a bank so it can be used in the future. Many medical treatments can damage sperm quality, including several types of cancer treatments like chemotherapy and radiation. Before getting medical treatment, some men choose to freeze their sperm.
Procedure for Sperm Freezing
- • The male partner based on the reference of Fertility expert will be advised to maintain an absence of sexual intercourse or masturbation fora period of 3to 5 days before sperm freezing.
- • The semen sample is collected by the masturbation method in a sterile container and kept in a 37°C warm water bath for liquefaction of semen.
- • The liquefied semen is mixed in 1:1 ration in freezing medium and this allows your sperm to survive the freezing and storage process.
- • Semen samples are then frozen slowly in liquid nitrogen vapors. Once the semen samples have been frozen, they are stored in the liquid nitrogen until they are needed.
- • Each ejaculate can yield between one to three vials.
- • Each vial of a patient’s semen sample is labeled with the patient’s name, date, and a unique number recorded on the side. This information will be used to catalog your semen sample in the storage facility.
Test Thaw Procedure
After cryopreservation, the survival rate of sperm can vary widely.
Embryo cryopreservation (Freezing)
- • Women cannot conceive due to co-morbid conditions; the couple may wish to freeze their embryo instead of eggs.
- • If a woman is in a stable relationship, the couple may wish to freeze embryos instead of eggs.
- • The woman undergoes a cycle of ovarian stimulation and egg retrieval as in conventional IVF. On the day of egg collection, the male partner is asked to provide a fresh sample of semen, produced on-site in the Andrology Department.
- • All mature eggs retrieved are injected with a single sperm using a technique known as ICSI (Intra Cytoplasmic Sperm Injection). On average, about 50-60% fertilizes and form embryos.
- • The laboratory will ring you the morning after egg collection to tell you how many eggs fertilized.
- • The embryos at the 6 to 8 cell stage will be vitrified for fertility preservation.
- • Embryo freezing is a relatively successful procedure and follow-up studies on babies born are reassuring.
- • If the woman is below 35 years of age, approximately 1 in 3 couples will conceive following embryo freezing.
- • Embryo storage should only be carried out for couples in a stable relationship as, if the couple separates, the male partner may withdraw his consent for continued storage and treatment. As a result, the embryos would have to perish.
- • 24×7 Cryopreservation and Liquid Nitrogen Cryo Tanks
- • Laminar Air Flow Chamber
- • Stereo zoom Microscope
- • Nikon Inverted Microscope
- • Narishige Micromanipulator
- • Sterile straws and cryovials for storage