Fresh sperm vs. frozen sperm: Which is better?

A question that is frequently asked by our patients is, “should we use fresh or frozen sperm?” This is many times a logistical decision and recommendation rather than a diagnosis for the patients to freeze or not to freeze.

In general, biologists say that if the sperm is good, then it is ok to freeze the sperm. If the sperm is not good, then it is better to come on the day of egg retrieval and supply a fresh specimen.

Another thing biologists say is that they always prefer to use fresh sperm…so what are we to do?
In the freezing process sperm can lose motility and the fragmentation index can increase. These events do not take place in every spermatozoa, but the number of sperm that survive freezing is never going to equal the number found in the fresh sample.
When the sperm is excellent, the choice is easy: you can freeze. If the sperm is of very low quality, it is evident that sperm freezing may affect the outcome, so it is better that the man comes in on the day of the egg retrieval to give a fresh sample. Another frequent case where sperm freezing is a must is if the man has trouble ejaculating under stress, which can happen on the day of the egg retrieval. It becomes imperative to freeze because it helps the man to not be so stressed if he wants to try to produce a fresh sample on the day of egg retrieval. If he cannot, we have a frozen sample as a backup. Frozen sperm is always better than no sperm.
Another common reason for freezing sperm is the case of a man whose job involves travelling. If we have a frozen sample, it is much less stressful for everybody. Both members of the couple are more relaxed, and we as doctors have the sperm on hand in case there is a surprise trip or the man cannot make it to the clinic because of flight cancellations or weather problems. This is always positive.
Sometimes there are work problems and the woman is the one who can easily get time off and the man is able to take a specific day off to come freeze. In this case, freezing is definitely the best option.
As a doctor in this field, I think that the idea of freezing sperm is always good as a back up, no matter what the sperm quality is. Still, the very best method, regardless of the quality of sperm, is for the man to give a fresh sample on the day of the egg retrieval.

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