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CION Cancer Clinics
Sperm banking before orchidectomy | CION Cancer Clinics
Sperm banking, which means freezing a semen sample for later use, is done before the orchidectomy whenever the surgery can wait a day or two, and always before any chemotherapy or radiotherapy. The remaining testicle often has a lower count than expected, so banking early captures the most. This page explains the timing, the steps at the laboratory, what to do if your situation is unusual, and what the page cannot tell you. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- When should sperm be banked, before or after the operation?
- How is sperm banking actually done?
- What if your situation does not fit the usual pattern?
- Which words will you meet, and what do they mean?
- What families say about sperm banking, and what is actually true
- What should you take to the fertility laboratory?
- What this page cannot tell you
- Common questions about sperm banking before orchidectomy
The short answer
When should sperm be banked, before or after the operation?
Before the operation, if it can be arranged without a long delay. Sperm banking means freezing a semen sample so it can be used later. It takes a day or two to organise and does not hold up the surgery in most cases. If the operation cannot wait, banking is done straight afterwards, and always before any chemotherapy or radiotherapy.
Why before the operation
Many men with testicular cancer already have a low sperm count in the other testicle before anything is done. Removing one testicle lowers the total further. Banking before surgery captures the most sperm you will have, and the sample is safely stored before anyone knows whether chemotherapy will be needed.
If the surgery cannot wait
Sometimes the markers are very high or the lump is growing fast and the surgeon wants to operate within days. Then the operation comes first. A sample can be given in the days after surgery, once the groin is comfortable, and it must be done before chemotherapy starts. Tell your oncologist on day one that you want to bank, so the timing is built into the plan.
Who this page is for
Any man who may want children in the future, whether or not he is married yet. The decision to bank is yours. Men who are sure they have finished their family often choose not to.
Sperm banking is arranged through a fertility laboratory. Ask your surgeon to refer you rather than searching for one alone.The process
How is sperm banking actually done?
Referral and consent
Your surgeon or oncologist refers you to a fertility laboratory. You sign forms saying how long the sample is to be stored and what should happen to it in different situations. Read them; they matter later.
Blood screening
A blood test checks for infections such as hepatitis and HIV. This is a legal requirement for storing any sample and is not a comment on you. The result decides how the sample is stored, not whether.
Producing the samples
You produce a sample by masturbation in a private room at the laboratory. Two or three samples, a few days apart, are usually asked for. You will be told how long to avoid ejaculation before each one.
Analysis and freezing
The laboratory counts the sperm, checks how well they move, and divides the sample into small tubes. These are frozen in liquid nitrogen. You receive a report of what was stored.
Storage
The tubes stay frozen for years. An annual storage fee usually applies. When you want to use them, the fertility clinic thaws what is needed for treatment with your partner.
Not sure whether this applies to you?
Ask an oncologistWhen it is not straightforward
What if your situation does not fit the usual pattern?
Most of these have a workable answer. None of them means banking is off the table.
You cannot produce a sample
Pain, anxiety or the setting can make it impossible on the day. Tell the laboratory; it is common. Another appointment, medication, or a sample produced at home and brought in quickly are all options.
The count is very low or zero
Even a few sperm can be frozen and used later with a technique that injects one sperm into one egg. If no sperm are found, sperm can sometimes be taken directly from testicular tissue under anaesthetic, occasionally from the removed testicle itself.
The operation has already happened
Bank now, before chemotherapy or radiotherapy. The remaining testicle is still producing sperm. Sample quality can be lower in the weeks after surgery, which is another reason to freeze more than one sample.
You are not married and feel awkward
The laboratory sees young single men every week for exactly this reason. Nobody needs to know beyond you and the team. The forms let you decide alone what happens to the sample.
On the laboratory report
Which words will you meet, and what do they mean?
- Semen analysis
- The count of sperm in the sample, how many are moving and how many are normally shaped. Done on every sample before freezing.
- Azoospermia
- No sperm found in the sample. It does not always mean none are being made; some can sometimes be found in the testicle itself.
- Cryopreservation
- The formal word for freezing and storing the sample. It is the same thing as sperm banking.
- Straws or vials
- The small tubes the sample is divided into. Each can be thawed separately, so one attempt at treatment does not use everything.
- ICSI
- A fertility treatment in which a single sperm is injected into an egg. It allows a pregnancy from a very small number of frozen sperm.
- Consent to storage
- Your written instruction on how long the sample is kept and who may use it. It can be changed later, but only by you.
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Commonly believed
What families say about sperm banking, and what is actually true
"One testicle is enough, so banking is a waste of money."
One testicle is often enough for a natural pregnancy. But the remaining testicle may already have a low count, and any chemotherapy or radiotherapy afterwards can stop production for a long time or for good. Banking is insurance against the part nobody can predict yet.
"Banking will delay the cancer surgery."
It usually adds a day or two, which the surgeon can plan around. If the surgery truly cannot wait, banking is done afterwards instead. The one thing it must come before is chemotherapy or radiotherapy, and those are not started the day after surgery.
"Children from frozen sperm are weaker."
Frozen sperm has been used for decades and children born from it are as healthy as any others. Freezing does not change the sperm's genetic material. Ask the fertility clinic if you want to see what they tell every couple about this.
"We will decide about children after the treatment."
The decision about children can wait. The decision about banking cannot, because the sample has to be frozen before treatment changes it. Banking keeps the later choice open. Not banking closes it.
Practical
What should you take to the fertility laboratory?
- The referral letter from your surgeon or oncologist
- A photo identity document, needed for the consent forms
- Your planned surgery date, so the samples are timed around it
- A list of any medicines you take
- Your insurance or scheme card, in case storage is covered
- Questions written down, because you will forget them in the room
Being straight with you
What this page cannot tell you
This page cannot tell you what your sperm count is, whether you will need chemotherapy, or whether a natural pregnancy will be possible later. The first is answered by the laboratory, the second by the pathology report, and the third only by time. Banking is the step that keeps your options open while those answers arrive.
About the cost
There is a charge for the analysis and freezing, and a yearly storage fee. The amounts vary between laboratories. Some insurers cover banking as part of cancer treatment; many do not. Ask the laboratory for its written charges and ask your insurer directly.
Questions worth asking your team
Ask whether the surgery date allows time to bank first. Ask which laboratory they refer to and how quickly it can see you. Ask whether sperm retrieval at the time of the operation is possible if your count turns out to be very low. Ask who will remind you about storage renewal in the years ahead.
If you are reading this the night before surgery and have not been asked about banking, call the helpline in the morning. It may still be possible.Questions we are asked
Common questions about sperm banking before orchidectomy
How many days does banking add before surgery?
Usually one to a few days. The laboratory can often see you the day after referral, and samples a few days apart are preferred but not essential. If your surgeon wants to operate sooner than that, one sample is better than none, and more can be banked after the operation.
Can I bank sperm after the operation instead?
Yes. The remaining testicle keeps producing sperm. Give the samples once the groin is comfortable enough, and before any chemotherapy or radiotherapy. Counts can be lower in the weeks after surgery, so ask to freeze more than one sample if the first is poor.
Is banking needed if I am only having surveillance?
Nobody knows at the time of surgery whether surveillance is all you will need, because that depends on the pathology report and the scans afterwards. Banking before surgery covers you whichever way the report goes. If you need nothing more, the sample simply stays stored.
How long can the sample be stored?
Many years. Storage is renewed regularly, usually yearly, and the laboratory contacts you when renewal is due. Keep your phone number and address updated with them. A sample stored for a long time is as usable as one frozen last month.
Will my parents or wife be told the results?
Only if you say so. The sample and the report belong to you, and the consent forms record who may be told and who may use the sample. If you want your wife or a parent involved, you can add them. If you want it kept private, it stays private.
What if I feel too unwell or anxious to produce a sample?
Say so. It is common and the laboratory has ways round it: a second attempt on another day, medication, or producing the sample at home and bringing it in within a short window. If no sample is possible, surgical retrieval of sperm can be discussed with your surgeon.
Does a low count mean the sample is useless?
No. Fertility treatment can achieve a pregnancy with a small number of sperm by injecting a single sperm into an egg. The laboratory will freeze what is there and tell you honestly what it is likely to be good for. A poor sample is still worth keeping.
Is sperm banking covered by Aarogyasri or insurance?
It varies, and often it is not. Aarogyasri, CGHS, ECHS and EHS cover the cancer surgery itself; banking and storage are usually separate. Some private insurers cover it as part of cancer care. Ask the laboratory for its charges in writing and ask your insurer directly. Call the helpline if you want help asking.
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Sources
- National Cancer Institute — Fertility issues in boys and men with cancer
- NHS — Testicular cancer: treatment
- NICE — Fertility problems: assessment and treatment (CG156)
- American Cancer Society — Fertility and sexual side effects
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Will One Testicle Be Enough for Fertility?What the remaining testicle can and cannot doOrchidectomy: What the Operation InvolvesThe operation banking is timed aroundSurveillance, Chemotherapy or Radiation After OrchidectomyThe treatments banking must come beforeTalking About It: Young Men and MarriageRaising fertility with a partner or familyChemotherapy guideHow chemotherapy affects the body, fertility included
Talk to us
Surgery is booked and nobody has mentioned banking?
Call the helpline or send us your surgery date. We will tell you whether there is time to bank first and how the referral works. One helpline serves every CION centre.