City Workers - Bank Your Sperm At Discounted Rate

Cryopreservation is the process of freezing tissue. In the case of sperm cryopreservation, a man’s semen is frozen for future use. A sperm cryobank is a facility that collects, stores and freezes the sperm. Generally speaking, there is little we can do to affect the future. Just out of reach, it rolls on indifferent to our wants and needs. One happy exception to this rule, however, is our ability to freeze sperm in a cryobank and thus preserve it for future use.

Maze Labs offers a full line of services to collect, freeze and store sperm. To ensure the future viability of your sperm, we first do a thorough semen analysis before banking. After each specimen is frozen for 48 hours, we then thaw a small sample and test it again to see how well it survived the freezing. That kind of attention to detail permeates everything we do. Each sample is stored in its own specially marked storage unit. As need requires, we may split up your specimens, storing part in separate nitrogen tanks or even different facilities to insure against equipment malfunction. Lastly, we check tanks daily for temperature and liquid nitrogen leakage. You might not expect a laboratory to be so long on personal attention but then we’re not just any laboratory. And it’s not just anybody’s future we’re keeping an eye on: It’s yours.

Sperm banking is, in most cases, a simple and straightforward process. It is not time consuming or “appointment intensive.” Although the process differs slightly between cryobanks, the basic procedure is the same: An appointment is set with the laboratory to meet with a lab representative, review your case history and medical background, and fill out necessary paperwork. Many labs require an initial test freeze of the sperm before actually conducting the banking and they may require that you return for a second appointment. However, there is no advantage to this.

In our lab, a full analysis is done on the first specimen (which requires very little of the specimen.) If it is adequate for cryopreservation, it is then processed and frozen. It is important not to waste this specimen, as often there is a small window of time to bank a man’s sperm, before treatment begins. This leaves only enough time for a man to produce and bank a limited number of specimens. You may be given a choice of producing a specimen at home or at the lab site.

If you choose to collect at a laboratory you will be given a private room. Visual material may also be made available to you. If you choose to collect at home you will be given clear and exact instructions. Ideally, if you produce the specimen outside of the laboratory, it would arrive at the lab within 60 minutes. However, though this is ideal, many of the sperm will still be alive hours after production. Do not assume that if your specimen does not reach the laboratory within an hour it is useless. Also, do not assume that just because you are hospitalized more than an hour away from the bank, that you will be unable to cryopreserve your sperm. It is important to ask all of these questions when arranging your appointment.

Frozen sperm must be stored in extremely cold temperatures (-196 F), but in order to insure that the fewest possible sperm are damaged, the freezing must be gradual. Generally, the following procedure is followed: If the sperm hasn’t been previously tested, a comprehensive semen analysis should be performed on the first specimen in order to give you a complete picture of your sperm quantity and quality. Make sure that your sperm bank conducts a thorough semen analysis before banking. This will give you significant information on the quality of the sperm, which helps determine how it can be used when you desire to initiate a conception.

Each subsequent specimen is analyzed prior to freezing to assess concentration, motility, forward progression, semen quality, and total number of moving sperm. Immediately after the specimen is analyzed, and prior to freezing, a special fluid (a cryoprotectant) is added to aid the freezing process. This helps the sperm survive the freezing and the subsequent thawing process, which is performed when they are ready to be used or tested. The combination fluid (semen plus cryoprotectant) is then divided into portions and placed in separate vials. Each vial holds up to 2cc’s. (A teaspoon is 5cc’s.) A small amount of the combination fluid (specimen and cryoprotectant) is placed in a separate vial (test or T- vial). This is usually about 0.2 cc’s or less. The test tubes are gradually frozen. After 30-60 minutes they are transferred into liquid nitrogen tanks for permanent frozen storage. After a minimum of 24 hours has elapsed from the time of the initial freezing, the test vial is thawed and tested again to ascertain from each specimen how well the sperm survived the freezing, in terms of number of sperm, percentage moving, and quality of the movement.

From these results, we will be able to project with reasonable accuracy the quantity and quality of moving sperm that will be found in each of the storage vials when they are thawed for use in the future.

Vial Labeling: Each vial is assigned a unique accession number, and is labeled with six pieces of information: Patient’s full name Banking Date MAZE Laboratories Accession number Patient’s date of birth Patient’s social security number Vial Storage: The vials are placed in temporary storage until you are finished banking, and all of your blood work comes back and shows that you are negative for infectious diseases. Then they are placed into permanent storage, in large tanks. Within the tanks, there are individual racks, with numbered slots. Each vial goes into a unique slot, the identity of which is recorded and then saved in multiple locations, so it can be easily and accurately found. One tank versus two tanks.

At Maze, we store almost all patients’ specimens in two different tanks, in two different locations. This is added protection, in case there was ever a problem with a tank. Though the chances of this happening are extremely low, we believe it’s worth taking the added precaution of a second tank. How are the tanks monitored? Each tank has its own continuous temperature monitoring system. If the temperature increases even slightly, to a few points above -196 F, then the alarm goes off. (The sperm are still safe at temperatures way above this.) The alarm is then sent through an automatic calling system to alert our staff, one of whom is on call at all times, who will rectify the situation. The system has a large back up battery in our offices, and then a backup generator connected to this. It is important that you ask a sperm bank how their tanks are monitored prior to considering using their services. We have been amazed that some banks do not have continuous monitoring, and no alarm system whatsoever. They rely entirely on periodic checks of the tanks.

In order to decide how many specimens to bank, it is important to understand how they will ultimately be used, when and if you need them. One of the most important advantages of Maze Cryobank is that its medical director, Michael Werner, MD, is a specialist in male infertility. He will be reviewing the results of your bankings as they are happening, and helping you decide how many specimens make sense in your particular case. Active decisions must also be made, in real time, as a particular specimen is being prepared, in terms of how many vials are made from it, and what volume they should be. This will depend on several factors, including the volume of the ejaculate, the quality and quantity of the sperm, and how many bankings you will have time for prior to beginning treatment.

The number of specimens you should bank will depend on several variables:

1. How Many Sperm You Have in the Post-Thaw Specimen. As can be seen above, if you have enough sperm in the post-thaw specimens to do IUI’s, you will want to have enough vials to do several IUI’s and have some vials left over so that you can do some IVF’s in case the IUI’s are not successful. Thus, men with total post thaw motile counts of greater than 10 million sperm/vial, will want to have on, average, 12-15 vials. The men with total post thaw motile counts between 3-9 million/vial, will probably want almost 20 vials, so that some can be pooled to get up to 10 million for each IUI attempt. Some vials should be reserved for IVF if the IUI’s are not successful. Most men with post thaw motile counts of less than 2 million will probably only need 10 vials. Each vial can be used for an IVF, and there are very few situations where more than 10 IVF’s could be reasonably anticipated. Some men have extremely low numbers of sperm in the ejaculate, and some, if not all, of their specimens would be anticipated to have very low numbers of moving sperm post-thaw. In these cases, sometimes many specimens are banked to make it more likely that any moving sperm will be found post-thaw. In other words, sometimes multiple vials may be needed even for an IVF, in order to find enough moving sperm to have one for each egg.

2. How Much Time You Have to Bank. Before Beginning Treatment Some men are banking sperm because they are very ill and treatment is imminent. They may only have time for one or two specimens before treatment is started. We often receive specimens from hospitalized patients who are too sick to be discharged from the hospital prior to treatment. We try our best to make sure that each man gets 10 vials. We divide them up to give us more options in terms of using them (see above.)

3. Who Your Partner is Going to Be. Many men bank who are already partnered with a particular woman. Some may even already have children, but know they want more, or want to leave the option open. If possible, they should bank enough sperm for IUI’s and then IVF if necessary, as described above. Many heterosexual men bank, without knowing who their partner will be. They will want to leave open the option of having enough sperm for IUI’s and then IVF if necessary. They will want to have the option of initiating several conceptions. Many gay men bank their sperm in anticipation of becoming fathers. Most will need to use a donor egg and a gestational surrogate. In these cases, IVF must be used, and 10 vials are usually needed. If they may be in a situation where the woman carrying the child is also supplying the eggs, then IUI’s are an option, and more vials may be needed.

Once you are ready to initiate a conception, you will need to begin working with an ob/gyn. If IUI’s are being considered, some general ob/gyn’s are comfortable with this process and will stay involved. In most cases, a specialist in female infertility, called a reproductive endocrinologist (RE) will be involved. The female infertility specialist will want to know the quality and quantity of the vials you have stored, as well as the woman who will be both supplying the eggs and carrying the child (which may be the same woman or two different women), prior to deciding how to best use them to achieve a conception.

Often, Dr. Werner, an expert in male infertility and andrology, will work with you and your female infertility specialists to determine the best course of action. Once the number of vials to be used in a particular cycle has been determined, it will be your responsibility to contact our laboratory to release the specimens. You will also need to contact your RE’s lab so they are prepared to receive them. We will help make this easy for you. You then have the option of renting a small portable tank, and transporting the specimen yourself. Or you can have us ship the specimen in a larger tank for you.

How long should I store my sperm? Pregnancies have been initiated with sperm that have been frozen (cryopreserved) for up to 21 years. However, there is no indication that sperm cryobanked for even longer are not capable of initiating a conception. Thus, it is important to bank your sperm for any of the indications listed above, no matter how long you think it may be before you would use them, or even if you are not sure you ever plan to have a family. You should bank for as long as you think you may need the sperm. You should hope for the best outcome in terms of sperm production post treatment, and plan for the worst.

If you are young, and not anticipating trying to initiate a conception for a while, then you should bank for the maximal contractual time, which is 10 years. (Always remember that you can contract for additional time once your contract comes close to expiring.) If you are in a relationship, you should try to anticipate the farthest out you would like children for, and store for this period of time. In some situations, there is only a minimal chance that a drug or surgery will cause infertility. In this case, you may want to bank for only a year or two. Then, if post treatment testing shows good return of sperm and/or ejaculation, the frozen sperm can be destroyed.

How long should I wait after treatment to check my sperm production? Different courses of treatment have higher or lower probabilities of causing temporary or permanent damage to the sperm producing cells. Many men whose sperm counts go down dramatically during and right after treatment will have return of sperm production over time. Sometimes, their post treatment counts are even better after a period of time than the ones they banked prior to treatment. This is because their original condition (i.e. cancer or other medical conditions) can itself suppress their sperm production. Once the condition has been treated, the sperm production may improve on its own. This may be true even of men with testicular cancer. The cancer in this testicle may be suppressing production of sperm in the opposite testicle. Once the cancer is removed, and if your body recovers from treatment, your specimens may be better after the orchiectomy than prior to it. Unfortunately, they may also be worse, if there is damage to the remaining testicle from treatment, or if the remaining testicle never had good sperm production to begin with.

In general, we would suggest waiting at least a year after treatment to check your semen analysis. If the one year post treatment semen analysis is worse than the banked specimens, we generally suggest you keep the banked specimens and re-check the semen analysis in another year. Some men may go down to zero for prolonged periods of time, and then gradually have some sperm production. The longer you are out from treatment, without the return of sperm, the less likely it will return.

There are numerous considerations that come into play when choosing a sperm bank and Maze Labs excels in all areas:

• Safety of your specimens — vials are stored separated in different tanks, each with constant monitoring
• Clinical expertise of director — both from a scientific point of view, and a clinical point of view
• Location and convenience — 2 locations, evening & weekend hours

Specimen Safety:

Some of your vials will be kept in a tank in our Westchester office, and the rest in our NYC office. Though tank malfunctions are extremely rare, having two tanks builds in an extra safety net in case of an unforeseen disaster, either to a particular tank or a particular location. At Maze, each tank is continuously monitored 24/7/365. If the temperature or level falls, an alarm goes off, which then phones our lab technician or physician on call. The alarm system has a battery backup, and a generator back up as well.

Clinical Expertise:

Michael A. Werner, MD, the owner and Medical Director of Maze, is a board certified urologist, with a fellowship in Male Infertility, Andrology, and Male Sexual Dysfunction. He supervises the entire process of sperm banking, including determination of the optimal number of vials for each patient and how many times a man should bank. Additionally, he works closely with the female infertility specialist when it comes time to use the vials. This comes from his knowledge base in the field of fertility as well as in his scientific knowledge of sperm production, analysis, processing, and freezing.

Location:

Maze Labs has two locations. One is in Westchester County, in Purchase (right by the intersections of I-95, I-287, and the Hutchinson River Parkway.) The second is on Third Avenue between 40th and 41st Streets, two blocks from Grand Central Station in New York City.

Hours:

We have early morning, evening, and weekend hours. It is often important to get several specimens banked quickly before treatment begins. We go out of our way to make sure you can do this.