Is sperm cryopreservation an option for fertility preservation in patients with spinal cord injury-induced anejaculation?

ABSTRACT

OBJECTIVE: To evaluate the effects of cryopreservation on sperm mitochondrial activity and nuclear DNA integrity in men with spinal cord injury. DESIGN: Prospective controlled study. SETTING: Patients in an academic research environment. PATIENT(S) Men with and without spinal cord injury-induced anejaculation. INTERVENTION(S) Electroejaculation or penile vibrating stimulation semen cryopreservation using a commercial TEST-yolk-buffer technique. MAIN OUTCOME MEASURE(S) Rate of sperm DNA fragmentation as assessed by the comet assay, graded in Classes I (high DNA integrity) to IV (high DNA fragmentation). Mitochondrial activity as assessed by a method in which active mitochondria precipitate 3,3'-diaminobenzidine. Cells were classified as I (all active) to IV (all inactive). Semen was cryopreserved in a Test-yolk buffer, and motility, DNA fragmentation, and mitochondrial activity were analyzed precryopreservation and postthaw. RESULT(S) Before cryopreservation, when the study (SCI) and control groups were compared, no statistically significant differences were found with respect to concentration or total sperm count; however, the SCI group presented significantly lower ejaculate volume, decreased sperm morphology, and an increase in the round cell and neutrophils counts. In both groups, cryopreservation was associated with an increase in DNA fragmentation, a decrease in mitochondrial activity, and a decrease in motility, of which the latter was of greater importance in the control group. CONCLUSION(S) Cryopreservation causes a decrease in conventional seminal variables as well as in mitochondrial activity and DNA fragmentation. However, these were no more detrimental to sperm from men with SCI than to sperm from the control group.