Module - Sperm Processing and Cryopreservation (SLS337)

STP

Aim of this module

This module will provide trainees with the knowledge and understanding of the different reasons males seek fertility preservation, the principles and practice of cryopreservation and associated regulatory requirements.This module will consider the techniques of sperm processing and cryopreservation critically evaluating the principles, practices and risks alongside the evidence base to optimise the chance of having healthy offspring. The trainee will explore ethical and safety issues including patient, partners and family perspectives and what is required of a clinical scientist by the Health and Care Professions Council. They will understand and gain experience in sperm preparation and insemination methodologies. The trainees will also learn how to report results from freezing and thawing. Trainees should gain insight into patient perspectives and information sharing with patients and how well this is understood.

Work-based learning outcomes


  1. Review a set of case notes and recommend a patient’s pathway, including treatment options based upon clinical presentation.
  2. Perform sperm preparation, cryopreservation and thawing, post thaw preparation within the statutory and regulatory framework.
  3. Handle gametes correctly to maintain viability and perform different methods of sperm preparation techniques within the statutory and regulatory framework.
  4. Perform quality control checks within the laboratory and the cryofacility.
  5. Analyse key performance indicators with respect to defined outcomes then identify, troubleshoot and solve any problems.
  6. Provide relevant information on results of banking attempts to patients / prospective donors.

Work-based Competencies


Learning outcome Title Knowledge
1 1,4,5,6

Obtain consent from a range of patients referred to Andrology Services.

  • Recording the correct information and HFEA form familiarity.
  • Requirements associated with taking consent in different situations.
  • The limits of confidentiality.
  • The role of counselling.
  • When and how to offer counselling.
2 2,3,4

Maintain and select culture systems.

  • Practical and theoretical knowledge of equipment for culture systems, its validation, maintenance, cleaning/sterilisation and troubleshooting.
  • Important parameters to monitor for QC/QA and their frequency.
3 1,3,4

Perform and interpret swim-up techniques and density gradient separation of sperm samples of different quality, including:

  • antisperm antibody-positive samples
  • retrograde samples;
  • severe oligoasthenozoospermic samples (for cryopreservation);
  • frozen samples, including donor samples.
  • The importance of how suboptimal samples may affect future outcome.
  • The different methods that can be applied to prepare semen samples of differing qualities.
  • The cost effectiveness and yields associated with different techniques.
  • How cryoprotectants may affect the quality of sperm and how osmotic shock may occur during the process.
  • Implications of incorrect use of cryoprotectants on sample quality and outcomes.
4 2,3

Label and perform witnessing prior to cryopreservation and following thawing/warming of semen.

  • The HFEA Code of Practice with respect to witnessing requirements and the implications of incorrect witnessing procedures.
  • Observe  the  manual  and  electronic  witnessing procedures with awareness of the accompanying risks.
5 2,3,4

Perform sperm cryopreservation Correctly use and handle liquid nitrogen and associated cryogenic equipment.

  • The required consents that need to be completed before any samples can be stored and the implications for the centre if consents are not completed.
  • The principles of cryobiology, including the physical and chemical processes occurring during cryopreservation and thawing, and the use and properties of cryoprotectants.
  • Were and why sperm losses are most likely to occur during the cryopreservation process.
  • The health and safety regulations to be applied when handling liquid nitrogen.
  • The safe working practices in a cryofacility.
  • The regulatory requirements with regard to screening and storage limits.
6 2,3,4,5

Thaw semen samples and compare pre-freeze and post-thaw parameters.

  • How cryoprotectants may affect the quality of sperm and how osmotic shock may occur during the process.
  • Implications of incorrect use of cryoprotectants on sample quality and  outcomes.
  • The physiological changes that occur in sperm during cryopreservation.
  • Assessment of post-thaw samples and whether these are suitable for use in sperm donation.
  • How removal of cryoprotectants may affect the quality of sperm and how osmotic shock may occur during the process.
7 2

Release and receive cryopreserved gametes and embryos to other centres.

  • The regulatory requirements with regard to moving samples between centres including: the correct handling of a shipping container, its labelling, associated documentation.
  • Importance of maintaining appropriate conditions during transport to ensure viability is not compromised.
  • The risks associated with the transport of frozen samples and the contrast in risk between donor and patient material.
8 2

Fill and label a nitrogen shipping container.

  • The regulatory requirements with regard to moving samples between centres including: the correct handling of a shipping container, its labelling, associated documentation.
  • Importance of maintaining appropriate conditions during transport to ensure viability is not compromised.
  • The risks associated with the transport of frozen samples and the contrast in risk between donor and patient material.
9 2,5

Work safely in the laboratory to reduce the risk of transmission of infections, e.g. blood-borne viruses.

  • The importance of maintaining the safety of both service users and those involved in their care.
  • Effects for storage and fertility treatment for serodiscordant/concordant couples for HIV, HBV and HCV
  • Treatment and storage options for serodiscordant couples
  • Screening for other transmissible disease.

Work-based assessment


Complete 2 Case-Based Discussion(s)
Complete 2 of the following DOPS and/or OCEs
Type Title
DOPS Prepare sperm from semen in compliance with relevant local practice by gradient and swim-up methods
DOPS Culture prepared sperm and control media for 24h to assess aseptic preparation technique
DOPS Perform QC checks within a cryofacility
DOPS Perform slow freezing of sperm samples and review how method optimization may improve survival / sperm quality.
DOPS Correctly complete HFEA consents for sperm storage and use with a patient
DOPS Provide results of a sperm banking event to a patient / donor.
OCE Review a number of sets of case notes and recommend patient pathways including treatment options based upon these.
OCE Present to the laboratory team a summary of the dangers of liquid nitrogen use and how to mitigate these.
OCE Evaluate the potential effects on a potential sperm donor / banking patient of unexpected findings about their fertility, particularly with regard to azoospermia. Discuss with your team how these relate to best practice locally.