Cryopreserved sperm among patients with Oligoasthenoteratozoospermia

•Almost half of OAT patients adopted a "wait-and-see" approach, preserving sperm without decisions for over 10 years.•Age and parenthood didn't significantly influence decisions on sperm use or disposal after 10 years in OAT patients.•Unique decision-making in OAT patients underscores uncertainty about future fertility and long-term sperm cryopreservation. This study investigates sperm utilization and disposal patterns in Oligoasthenoteratozoospermia (OAT) patients undergoing long-term sperm storage. OAT is a major contributor to male infertility. Cryopreservation is a common practice as a “fertility insurance” in case of further deterioration until azoospermia. However, long-term storage practices and utilization rates remain unclear. In this retrospective study spanning from October 1993 to December 2021, we examined men diagnosed with OAT who underwent spermatozoa cryopreservation. Data from medical records included utilization and disposal of sperm samples, age and paternity status at initial cryopreservation. We analyzed the data over 10 years using Kaplan-Meier curves, compared age and paternity status with the log-rank test. Among 238 patients undergoing semen cryopreservation due to the indication of OAT, 45 utilized sperm for fertility treatments, with a third using all frozen straws and others using only a portion. Sixteen patients used sperm due to azoospermia. Additionally, 54 requested the disposal of all cryopreserved straws. A Kaplan-Meier analysis revealed that after 10 years, 25.9 % of men used cryopreserved sperm, while 31.2 % opted for disposal. Most participants did not use or dispose of preserved sperm. After 10 years, no significant differences were observed in usage or disposal based on age or paternity status. Our analysis of sperm utilization in OAT patients undergoing cryopreservation revealed a key finding: nearly half exhibited a “wait-and-see” approach. Unlike other indication for sperm preservation, age and paternity did not significantly influence utilization or disposal decisions. This suggests unique factors drive decision-making in OAT patients, highlighting the need for tailored cryopreservation management strategies.