Once you’ve made the decision to bank your sperm, you may be wondering what your options are should you want to conceive a child in the future and use your cryopreserved sperm to achieve that goal. The processes available for using your banked sperm are the same for those with infertility problems, because regardless of why you banked your sperm, conception will not occur naturally through copulation, and this means you will most likely use assisted reproductive technology (ART) to conceive.
ART allows families with fertility problems, or those with cryogenically preserved sperm, a chance at conception. Various techniques have been developed, each with benefits depending on the underlying condition. This article will describe how the five most common assisted reproductive technologies work and utilize banked sperm.
1. Intrauterine Insemination (IUI)
This is the simplest and most common ART procedure available. It is designed to assist fertility by bypassing the vagina and cervix.
To begin, the fertility specialist will either coordinate the procedure with the woman’s normal ovulation cycle, or prescribe fertility medications to help stimulate ovulation prior to the procedure. Once ovulation occurs, fresh or thawed cryopreserved sperm are washed and concentrated before they are injected directly into the woman’s uterus via a catheter. From there, the sperm travel to the fallopian tube just like they would in a standard conception.
IUI, a procedure that costs an average of $895, can be used if:
- The male partner has low motility or a low concentration of sperm
- The male partner is unable to perform intercourse (due to erectile dysfunction or other problems)
- The woman has a semen allergy or thick cervical mucus, which enables sperm from traveling from the vagina to the fallopian tubes
- The woman has a blockage of the cervix that prevents sperm from entering the uterus
- The couple has unexplained fertility
2. In vitro Fertilization (IVF)
IVF is a multi-step process of fertilization that occurs outside of the body. The process begins with multiple eggs being removed from the woman via laparoscopy. In the lab, fresh or thawed sperm is added to the eggs and incubated to trigger fertilization. Once the fertilized eggs become embryos, 1-2 are implanted into the woman’s uterus, where it will proceed as a common pregnancy. Any additional embryos are frozen for future cycle attempts, if necessary.
IVF, which runs about $8,000 per cycle, are useful in cases where:
- The man has low semen quality
- The woman has a fallopian tube blockage
- The couple has unexplained fertility
Not only is IVF costly, but it entails a demanding regiment of fertility drugs.
3. Intra-cytoplasmic Sperm Injection (ICSI)
The ICSI procedure is similar to IVF, but instead of mixing the sperm with the eggs—which requires the sperm to penetrate the egg’s outer layer—a single sperm is isolated from the man’s thawed cryopreserved sample (and, of course, fresh sperm can be used too). A physician injects this sperm directly into the egg using a microscopic needle. Once this fertilization results in an embryo, it is placed in the woman’s uterus, where a standard pregnancy then occurs.
ICSI has it uses—such as when a man has very low quality sperm or low motility, or when IVF has failed and available sperm supply is limited—but it too can be costly. On average, each cycle costs between $1,000 and $2,000. If IVF becomes part of the process, expenses will inflate.
4. Gamete Intrafallopian Transfer (GIFT)
In a GIFT procedure, a fertility specialist removes eggs from the woman’s ovaries and combines them with fresh or thawed cryopreserved sperm. This procedure may sound similar to IVF and ICSI, but after the eggs and sperm are mixed, they are placed directly inside the fallopian tube—where fertilization occurs—and prior to embryo development. This means that fertilization does not occur in an incubator; rather, it happens in the woman’s fallopian tubes. From there, a natural pregnancy may take place, meaning the fertilized egg(s), if successful, will move down the fallopian tubes and develop into an embryo then implant into the uterus.
Because GIFT allows fertilization to occur naturally inside the body, it may be preferable to some couples. It can also be used when a woman has a function fallopian tube and the man has a low sperm count, or if IVF is unsuccessful. However, the procedure comes with a few downsides, like any other assisted reproductive technology:
- Though the fertility specialist will choose the healthiest, most viable eggs and sperm, there is no way to ensure the eggs will become fertilized. And at a cost of $15,000-$20,000, this uncertainty makes IVF a more appealing procedure since the eggs are placed in the uterus after fertilization has taken place, which increases the chances that pregnancy will occur.
- More than one surgical procedure is required: first egg retrieval, then laparoscopic surgery to put the sperm and eggs into the woman’s fallopian tubes.
5. Zygote Intrafallopian Transfer (ZIFT)
ZIFT is similar to IVF in that the eggs of the woman and the sperm of the man are mixed and fertilized outside of the body in a laboratory dish. The next day the resulting zygotes (fertilized egg cells) are placed in the fallopian tubes, versus the uterus, much like with GIFT. The zygote then develops into an embryo as it travels down the tubes to the uterus, where it will implant in the uterine wall and the pregnancy will proceed as normal.
On the upside, there is confirmation of fertilization before fertilized eggs are returned to the body and fewer eggs are used, thus reducing the risk of multiple births. Another benefit is that ZIFT can be used when the woman has ovulation problems, the man has a low sperm count, or when couples have unexplained fertility issues. But the procedure can be costly—$8,000 to $13,000 per cycle—and invasive.
Whether you use your banked sperm on one of these ART methods or not, there is no official expiration date if the sperm is properly cryopreserved—cryogenically preserved sperm has been used to successfully impregnate women after 25 years of storage.
To learn more about how banked sperm is preserved, read Sperm Preservation: What You Need to Know