Human spermatozoa have successfully been frozen since 1953.  Generally there are two main categories of sperm freezing:  for homologous and for heterologous (donor) use.  Indications for homologous freezing are:

1. Preservation of reproductive potential before chemotherapy, radiation therapy or surgery
2. Availability of spermatozoa at the time they are required for infertility treatment (in vitro fertilization, intrauterine insemination):  absence of husband, performance anxiety and previous poor specimen at on-demand occasions
3. Storage before vasectomy
4. Supernumary spermatozoa after a surgical intervention to obtain spermatozoa (e.g. microsurgical epididymal sperm aspiration with in vitro fertilization and intracytoplasmic sperm injection)

Prediction of sperm recovery after freezing and thawing, the number of recovered motile spermatozoa, is possible by the application of computer-aided semen analysis to the prefreeze specimen.  Straight-line velocity, linearity, curvilinear velocity and the amplitude of lateral head displacement are the most common predictors.  Successful cryopreservation is dependent on the rates of freezing, above and below the freezing point, and the composition of the solution in which the spermatozoa are frozen.  To avoid damage due to cold-shock, protocols are used which freeze at a slow rate from room temperature to the freezing point (1-2 degrees per minute).  For further protection, cryoprotectants and extenders are added to the freezing medium.  Thawing is usually performed in a slow-thaw protocol in 20-35 degree air.  If cryopreserved semen is employed for donor use, a strict protocol including screening for transmissible disease of each delivered specimen and a quarantine period to monitor possible seroconversion of the donor is mandatory. 

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