Cryopreservation of Testicular Tissue
In cases of azoospermia (absence of sperm in the ejaculate), severe oligozoospermia (very few sperm in the ejaculate) or high levels of sperm DNA fragmentation, a testicular biopsy may be suggested.
A testicular biopsy is a surgical procedure, performed under sedation, during which fragments of testicular tissue are removed. It may be possible to recover sperm from this tissue. In this case, the tissue can be cryopreserved for later use.
About Testicular Tissue Cryopreservation
In order to carry out Medically Assisted Reproduction treatment, it is necessary to obtain sperm. When it is not possible to obtain sperm from the ejaculate, a testicular biopsy may be used.
Testicular biopsy is a surgical procedure, performed under sedation, during which fragments of testicular tissue are removed from one or both testicles. It may be possible to recover spermatozoa from the tissue collected. These spermatozoa can be used for fresh intracytoplasmic sperm microinjection (ICSI), i.e. a few hours after collection. Another option would be to cryopreserve testicular tissue for future use.
Cryopreservation of testicular tissue after biopsy is indicated in cases where spermatozoa are recovered but where MAP treatment will be carried out at a later date.
Once the testicular tissue has been biopsied, it is examined and processed in the laboratory. To do this, the entire tissue is macerated using scalpels to release the spermatozoa present in the tissue tubules. The sample obtained is analysed under the microscope and the presence of spermatozoa is confirmed. In this case, the sample will be treated with appropriate culture media and cryoprotective solutions. Finally, the treated testicular tissue is cryopreserved in devices called straws, which are stored in liquid nitrogen containers (-196 o C).
Common questions
It cannot be ruled out that some spermatozoa may not survive the cryopreservation and thawing process.
The technique used with these samples is intracytoplasmic sperm microinjection (ICSI).
Under current Portuguese law, testicular tissue can remain cryopreserved for a period of 5 years, after which the patient must sign a new consent form to maintain cryopreservation for a further 5 years.
Cryopreservation of testicular tissue takes place after a testicular biopsy during which spermatozoa are recovered.
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