Assessing online price transparency of sperm cryopreservation across the United States

Comprehensive Analysis of Mail-In Andrology Kits Compared to Traditional Clinic Collection

OBJECTIVE

To evaluate mail-in semen collection services for cryopreservation, focusing on costs, transparency, and efficacy due to the advancements of direct access to fertility testing and treatment.

METHODS

Using Google, we identified eight prominent companies offering mail-in sperm cryopreservation services. We analyzed their costs, storage practices, marketing strategies, and prescription requirements. For comparison, we examined academic institutions offering similar services, exploring differences in pricing, processes, and accessibility.

RESULTS

The average upfront cost to process and freeze sperm was $730 (range $329 to $1575) with 10-year storage costs of $3117, on average (range $1450 to $5500), which may or may not be guaranteed to remain level. Not all services disclosed future costs such as transport, thawing, and disposal fees, with some firms being less transparent. Two firms offered client depositor storage on-site and the remainder outsourced to partner labs scattered around the country. One facility offered storage of tissue samples for men with azoospermia; none of the companies required men to have an order from their doctor to use the service.

CONCLUSION

Mail-in cryopreservation services provide convenience but present challenges, including varying costs, transparency issues, and potential limitations in medical oversight. Integrating these services into traditional healthcare settings could optimize patient outcomes and satisfaction.

The Importance of Fertility Preservation in the Transgender Population

OBJECTIVE

To call to attention the often-overlooked aspect of pediatric transgender care: the importance of fertility preservation prior to instituting gender-affirming therapy. The transgender population has long been marginalized by society. Societal stigmata, fear to seek care, and dearth of provider knowledge regarding transgender health issues have caused disparities to widen. Gender-affirming procedures and hormone therapy affect the long-term reproductive potential of transgender individuals. While cost concerns and insurance coverage regarding oncofertility is a prominent area of discussion, the transgender community is often excluded.

METHODS

Sixteen genetically XY females, followed by their multidisciplinary transgender care teams, were interested in starting hormone therapy due to impending onset and/or progression of puberty. Their physicians were aware of fertility struggles after undergoing hormone therapy and therefore referred to urology. Sperm cryopreservation via open gonadal biopsy, testicular tissue cryopreservation (TTC), and semen sample (when age/maturity-appropriate) were discussed. Though requiring surgery, biopsy/TTC relieves patients of the psychological impact of semen sample production.

RESULTS

Under IRB approval, 15 patients (median age 12 years, range 10-16 years) underwent TTC (Fig. 1). One patient (aged years) opted for semen sample. All patients had success with spermatogonial stem cells cryopreserved for future patient use.

CONCLUSION

With more individuals beginning medical and surgical therapy at a younger age, fertility preservation discussions are essential but often overlooked, depriving these individuals the joy of becoming a biological parent. TTC can be safely done in pediatric populations, though research is necessary to expand beyond current experimental stage of tissue development.

Testicular Cancer Survivorship and Fertility Preservation

Testicular cancer disproportionally affects men of reproductive age making fertility an important aspect of testicular cancer survivorship. Men with testicular cancer have more semen parameter abnormalities and a higher incidence of infertility compared to the general population. All treatment options for testicular cancer negatively affect fertility with recovery rates varying by treatment. For these reasons, clinicians should offer sperm cryopreservation, ideally before orchiectomy to maximize the possibility of biologic paternity, if desired. Several innovations have positively impacted this space including direct-to-consumer cryopreservation and bench research demonstrating the feasibility of reintroducing testicular cells post-therapy.

And When I Die: Theory of Planned Behavior as Applied to Sperm Cryopreservation

The present study investigates fertility intentions of men, aged 18-59, as expressed in willingness to cryopreserve sperm for future use in procreation. An economic stated-preference framework is combined with the Theory of Planned Behavior (TPB) to investigate which attributes are important in the decision to cryopreserve sperm, what is the Willingness to Pay (WTP) for cryopreservation, and which attributes influence it. A structured, two-part questionnaire was used, based on WTP and Conjoint analysis (CA) applied in tandem to elicit respondents' preferences in evaluating utility. Findings show which attributes are important in the decision to cryopreserve sperm among them Risk of Infertility, Personal monthly income, Chance of pregnancy from frozen semen, Age and what are significant predictor variables for the WTP which are Personal monthly income, Importance of the risk of infertility, Initial registration fee to sperm bank and cryopreservation, and Degree of religious observance. The findings further demonstrate that respondents value sperm cryopreservation and have a positive WTP for it as it seems to contribute to improving well-being. As a result of these findings, governments should consider state funding for cryopreservation as part of national health policy.