Malignant diseases in adolescence and younger adults such as testicular cancer, lymphomas and leukaemia have long-term survival rates of up to 80% if treated adequately. As a result, long-term quality of life, including reproductive health, has become increasingly important. The cryopreservation of sperm from oncological patients represents the most frequent indication for the procedure. Depending on the substance and dosages administered, chemo- and/or radiotherapy, as well as surgical intervention, can lead to persistent azoospermia independent of the patienńs pubertal status. Theoretically, hormonal gonadal protection and retransplantation of germ cell stem cells preserved prior to chemotherapy offer options to preserve fertility, but neither approach has yet proven to be of clinical benefit. Therefore at present, cryopreservation of sperm prior to oncological therapy offers the only possibility of circumventing the deleterious effects of disease and therapy on fertility, thereby contributing to the personal stabilization of the predominantly young patients in this critical situation.
Currently, men undergoing diagnostic and therapeutic testicular biopsies, performed to detect sperm possibly remaining in the testis for use in intracytoplasmic sperm injection (ICSI) (Chapter 9.4.14), may opt for cryopreservation. Until histological examination is complete, the remaining tissue remains frozen, for later use or subsequent thawing or disposal.