Table 1.

Summary of Fertility Preservation Options in Males

Intervention	Definition	Comment	Considerations
Sperm cryopreservation (S) after masturbation	Freezing sperm obtained through masturbation	The most established technique for fertility preservation in men; large cohort studies in men with cancer	Outpatient procedure; approximately $1,500 for three samples stored for 3 years; storage fee for additional years*
Sperm cryopreservation (S) after alternative methods of sperm collection	Freezing sperm obtained through testicular aspiration or extraction, electroejaculation under sedation, or from a postmasturbation urine sample	Small case series and case reports	Testicular sperm extraction; outpatient surgical procedure
Gonadal shielding during radiation therapy (S)	Use of shielding to reduce the dose of radiation delivered to the testicles	Case series	Possible only with selected radiation fields and anatomy; expertise is required to ensure that shielding does not increase dose delivered to the reproductive organs
Testicular tissue cryopreservation; testis xenografting; spermatogonial isolation (I)	Freezing testicular tissue or germ cells and reimplantation after cancer treatment or maturation in animals	Has not been tested in humans; successful application in animal models	Outpatient surgical procedure
Testicular suppression with GnRH analogs or antagonists (I)	Use of hormonal therapies to protect testicular tissue during chemotherapy or radiation therapy	Studies do not support the effectiveness of this approach

Abbreviations: S, standard; I, investigational; GnRH, gonadotropin-releasing hormone.

^*Costs are estimates.