Sperm storage for patients having cancer treatment

Please read this page carefully. If you have any further questions, contact a member of the team at the Oncology Centre. The telephone number is at the end of this page.

Why sperm storage?

Some treatment for cancer can cause infertility. In some cases, this is temporary, but there is a possibility that it may be permanent. This could mean that you may no longer produce sperm in enough numbers, if at all, in order for you to father a child. We therefore offer sperm storage, whenever possible, before treatment begins. This may allow you to father a child after treatment if your own semen samples do not return to normal.

How are the samples collected?

An appointment will be made at the Edward Jenner Laboratory at Gloucestershire Royal Hospital for you to produce your samples. There are private facilities with an en-suite toilet where the sample can be produced. If possible, we would like to collect and store up to 3 samples before the start of your treatment. Ideally, these samples should be produced 2 days apart. When arriving at the laboratory to use the facilities, please report to reception. They will then contact a member of the cryopreservation team. On your first visit, please bring some form of photographic identification such as your passport or driving licence. It is possible to produce a sample off-site in exceptional circumstances. This will be discussed on a case-by-case basis.

What is the process of sperm storage?

Before you can store your sperm, you will be asked to complete some paperwork. This includes consent forms which are required by law and allow us to communicate with your doctor and other professionals involved in your care.

Each sample of semen will be dispensed into a number of ampoules (small plastic sterile containers) which are labelled and coded for identification. The ampoules will then be placed in 2 separate tanks and stored in liquid nitrogen (at -196°C) within the Microbiology Department of the Gloucestershire Hospital NHS Foundation Trust.

These tanks are regularly monitored and linked to the Gloucestershire Hospitals Switchboard in case of emergency. Every effort will be made to keep your samples safe.

We cannot, however, accept any responsibility for loss or damage due to equipment failure. In the unlikely event that your samples were damaged or destroyed during an accident you will be informed.

If, due to technical or staffing problems, we are unable to store your samples, we will make every effort to get them stored at another licensed centre.

Which samples are suitable?

There are a number of factors, illness included, which can affect the quality of sperm even before treatment starts. Provided there are at least a few sperm present, each sample will be frozen and stored. Should there be no sperm present, your clinician will be notified and they will make contact with you to discuss your results.

How long can my sperm be stored?

The maximum time sperm can remain in storage is 55 years. However, you will be asked to formally renew your consent every 10 years.

We will also write to you on a regular basis to ask if you wish your sperm to be continued to be stored. This is also your opportunity to tell us about any changes in your circumstances as this may require updating your wishes on new consent forms. Examples include you having a partner for the first time or a change of partner.

It is your responsibility to make sure that your storage wishes remain up-to-date. You can withdraw consent for storage at any time or change your consent form if your circumstances change. It is very important that we are able to keep in touch with you, so please remember to let us know if you move house.

We will also contact you to let you know when your consent period is due to expire (end).

Is the service free?

Storage is free for up to 10 years unless you currently have living children or had a previous vasectomy operation. If this is the case you will be asked to pay for your sperm storage annually.

After 10 years or if you have children before then, you will be notified about future charging.

What are the implications of freezing sperm?

Artificial insemination using frozen sperm has been carried out for many years. There is no evidence to suggest any risk of abnormality in babies associated with the use of frozen sperm. We cannot however guarantee a pregnancy outcome from using the stored samples as there is some loss of fertilising ability in sperm samples from the process of freezing and thawing. The fertility of the frozen samples is therefore a combination of how good the samples were when they were frozen and the impact of the freezing process on the sperm.

However, with good quality samples and current techniques there are very good chances of achieving a pregnancy.

Will I need any other tests?

Yes. The Human Fertilisation and Embryology Authority (HFEA) requires testing of blood for HIV, Hepatitis B and C before storage.

A blood sample will be taken at the same time as your first sperm sample collection. Regardless of the blood test results, your samples will still be stored. If you have any concerns about these tests, or the results, please discuss them with your Oncology Nurse. You can contact the Clinical Oncology Centre to request to see a specialist counsellor at any stage of your treatment process.

What happens if I want to use my samples?

Should you wish to use your stored sperm in your partner’s treatment, you should contact the Clinical Oncology Centre and arrange an appointment to provide a sample for a sperm count.

If your sperm count has been affected by your treatment and it is necessary to use your frozen samples, there will need to be a detailed check of the sperm quality of the stored samples.

These complicated tests are only done at large fertility centres such as those in Bristol, Birmingham and Oxford and we may need to ask you to take a small portion of your stored sample to a centre such as this for testing.

The tests will also help decide whether it is necessary to consider using a technique called In Vitro Fertilisation (IVF) or whether the samples are suitable for insemination. In either case, these procedures are best done in a specialised fertility centre.

You should be aware that these tests and any subsequent infertility treatments may not be funded by the NHS and that you may be required to pay for this. The cost of fertility assisted conception treatments depend on the technique used. For further information please visit www.hfea.gov.uk. However, some people are eligible for fertility treatment funded by the NHS, this can be discussed with your GP if required.

What are the conditions of storage?

Sperm must be stored in accordance with the relevant law, the Human Fertilisation and Embryology Act 1990.

The Human Fertilisation and Embryology Authority (HFEA) is the regulator of fertility treatment in the UK. The law requires that you consent to the storage of your sperm and its future use.

We are normally allowed to store sperm for up to 55 years in total, subject to appropriate consent forms having been completed. These sperm are stored only for your use.

In the event of your death or medical incapacity, provided your consent has been given in writing, we will be able to continue to keep your samples in storage for a named partner’s use. We would then continue to contact your partner about their requirements regarding the samples. In the event of death or ongoing mental incapacity, sperm may only be kept in storage for a maximum of 10 years.

You will have to give instructions regarding what will happen to your sperm in the event of your death or mental incapacity.

Provided you have consented, you can also have your details recorded on the register of births as the legal father of a child born as a result of fertility treatment after your death.

At the end of the consented storage period, if the samples have not been used or have not been previously discarded with your consent, by law we will have to remove your sperm samples from storage and dispose of them. We will make every effort to contact you at this time, but if we do not succeed, we are still required to remove your sperm samples from storage and dispose of them.

The Clinical Oncology Centre will be happy to arrange analysis (sperm count testing) of fresh semen after your treatment to check whether you are still fertile.

Do I need counselling?

Fertility counselling provides an opportunity to discuss any concerns, thoughts or feelings you may have about the possibility that you may not be able to become a father.

This is a specialised field of counselling and we have partnered with Oxford Fertility Unit to provide this service. They can offer sessions face-to-face, by telephone and video calling. You can choose to be referred for this at the time of storing sperm or at any time afterwards.

This would be separate to any information or support you receive about sperm storage from the other staff involved in your care.

It would also be separate to any psychological support you may receive relating to your cancer diagnosis.

Confidentiality

The Human Fertilisation and Embryology Act 1990 includes a legal duty of confidentiality regarding your information. All staff adhere to this and information regarding your stored samples will only be released with your consent.

Contact information

If you have any questions or concerns, please contact any of the following:

Gloucestershire Clinical Oncology Centre

Cheltenham General Hospital

Tel: 0300 422 4028

Further information

Microbiology Department

Tel: 0300 422 5050

Monday to Friday, 9:00am to 5:00pm

The Human Fertilisation and Embryology Authority

Tel: 020 7291 8200

Website: www.hfea.gov.uk

Making a complaint

If you wish to make a complaint about any part of your treatment either at the oncology centre or the laboratory, please contact either:

Dr Alan Lees (Consultant Microbiologist), Microbiology Department, Gloucestershire Royal Hospital, Great Western Road, Gloucester GL1 3NN

Tel: 0300 422 4066

or

Patient Advice and Liaison Service (PALS)

Gloucestershire Royal Hospital

Tel: 0800 019 3282

Email: ghn-tr.pals.gloshospitals@nhs.net