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If you are planning medical treatment that may affect your fertility, our specialists can help you explore fertility preservation options. At the Center for Infertility and Reproductive Surgery (CIRS) at Brigham and Women’s Hospital, we help men and people assigned male at birth (AMAB) retrieve and store viable sperm until you are ready to have biological children.

What is Sperm Banking?

For most patients who have gone through puberty, sperm banking is the most straightforward preservation process. It involves collecting a sample of your semen and freezing it at extremely cold temperatures for future use.

What is the difference between sperm banking and sperm freezing?

• Sperm banking is the process of collecting and storing your sperm for future use
• Sperm freezing, also called sperm cryopreservation, is the laboratory technique used to make sperm banking possible.

What is rapid sperm freezing?

Rapid sperm freezing is a technique used to preserve as many sperm as possible. Your sperm sample is mixed with special chemicals that protect them from damage during the freezing process, then frozen quickly in liquid nitrogen to prevent ice crystals from forming. This process allows sperm to remain viable longer than traditional freezing.

How long will my sperm survive?

About 75% of sperm survive the initial freezing process. Once frozen, your sperm can last decades. Babies have been born from sperm frozen 40 years earlier. Some sperm die during thawing, but most samples remain usable for in-vitro fertilization (IVF) or artificial insemination.

What is Testicular Sperm Extraction?

Testicular sperm extraction (TESE) is a surgical procedure that extracts sperm directly from your testicular tissue. It may be recommended for prepubertal boys or AMAB individuals who cannot produce sperm naturally in their semen (azoospermia), due to a blockage or sperm production issues.

What happens during TESE?

1. You’ll receive general anesthesia so you are asleep and comfortable during the procedure
2. A surgeon will make a small incision in your scrotum and take a small sample of tissue from your testicle to check for sperm
3. The sperm is extracted from the tissue and preserved to fertilize an egg in the future

Does TESE hurt?

You shouldn’t feel any pain during the procedure itself because you’ll be asleep. However, it’s not uncommon to feel mild or moderate discomfort in your testicular region for a few days after the surgery. Ice packs, over-the-counter painkillers, and rest are usually enough to manage the discomfort. Most patients recover completely within 3-4 weeks.

When Should I Consider Sperm Banking or TESE?

Choosing to preserve your sperm is a personal decision. Some conditions may prompt you to do so to preserve your ability to have biological children. These include:

• Cancers that directly affect your reproductive system (such as testicular cancer)
• Certain cancer treatments that may affect your ability to produce sperm (radiation, chemotherapy)
• Some surgeries such as vasectomy or testicle removal (orchiectomy)
• STIs and other infections that can lead to sterility

In addition, if you’re a transgender patient, you may choose to preserve your sperm before gender-affirming treatment if you’d like the option to have biological children in the future.

No matter your reason for choosing fertility preservation, our specialists are here to answer your questions and help you make the best decision for your current and future reproductive goals.

Learn what causes infertility and which symptoms to watch for in our overview on .

Fertility Testing and Evaluation

Before your fertility preservation treatment, your fertility specialist will guide you through testing to evaluate sperm health and your fertility potential.

Common tests include:

• Semen analysis to check the quantity and quality of sperm
• Infectious disease testing to screen for any diseases or sexually transmitted infections (STIs) that may affect implantation or harm fetal development

After testing, your specialist will go over your results and discuss how much sperm you may want to preserve.

How Much Do These Procedures Cost?

• Sperm banking: About $1,000 for the initial collection, plus $150–$600 per year for storage
• TESE procedure: Typically between $1,500-$3,000, depending on the type of procedure

Some insurances may cover the costs of these procedures. Our team will check your benefits and help create a payment plan for any uncovered expenses.