精子冷冻的广泛应用给精子库带来了越来越大的负担。为了评估精子冷冻和使用的模式，在年龄和孩子数量的人口学参数以及冷冻指示方面的情况下，对30年来的精子冷冻和使用情况进行调查。本回顾性的、以人群为基础的队列研究包括了1993年10月至2021年12月期间在一家三级转诊中心进行的所有精子冷冻病例，年龄在18岁及以上的患者。首先，我们确定了第一次精子样本冷冻和使用之间的间隔。然后，我们分别研究了精子使用情况：（1）根据年龄，将患者分为5年年龄组进行比较；（2）根据孩子数量，确定父亲的状态；（3）根据指示，对七种指示进行比较。次要分析包括主要年龄组和与四种最常见指示相关的父亲的状态之间的相关性。在研究期间，共有1490名冷冻精子的男性符合纳入标准。第一次样本冷冻的平均年龄为33.9±8.1岁。第一次使用精子的平均年龄为37±8.5岁。经过17.8年，累计精子使用率为38.7%。年龄增长与精子使用率的逐渐增加和保存期间的缩短相关。使用率随着孩子数量的增加而显著减少。对精子冷冻的七种原因的研究发现，最高的累计精子使用率与无精子症相关（67.7%），其次是功能性冷冻（39.3%）、少而弱畸精子症（27.3%）、其他（26.5%）、患者要求（24%）、癌症（19%）和系统性疾病（7.2%）。次要分析确定了与年龄和指示密切相关的具体使用模式，而与孩子数量无关的影响较小。经过几十年的冷冻保存后，精子冷冻的范式主要与癌症患者有关。这一点应该重新评估，并扩大到包括更广泛的患者定向因素和认知。© 2023 The Authors. Andrology published by Wiley Periodicals LLC on behalf of American Society of Andrology and European Academy of Andrology.

The wide implementation of sperm freezing presents a growing burden on sperm banks.To evaluate sperm freezing and usage patterns over 30 years, according to demographic parameters of age at first cryopreservation and number of children, and indication for cryopreservation.This retrospective, population based, cohort study included all sperm cryopreservation cases performed at a tertiary referral center from October 1993 to December 2021, among patients aged 18 years and older. First, we determined the interval between first sperm sample and use. Then, we examined sperm usage separately for: (1) age, comparing patients grouped into 5-year age cohorts; (2) paternal status according to number of children; (3) indication, comparison among seven indications. Secondary analysis included correlations between main age groups and paternal status versus the four most common indications found.During the study period 1490 men who cryopreserved sperm met the inclusion criteria. Average age at cryopreservation of the first sample was 33.9 ± 8.1 years. Average age at first sperm use was 37 ± 8.5 years. Cumulative sperm usage was 38.7% after 17.8 years. Increasing age was associated with progressive increase in sperm usage rate and shorter preservation period. Use significantly decreased with increasing number of children. Examination of seven reasons for sperm cryopreservation found the highest cumulative sperm usage was related to azoospermia (67.7%), followed by functional cryopreservation (39.3%), oligoasthenoteratospermia (27.3%), other (26.5%), patient's request (24%), cancer (19%), and systemic disease (7.2%). Secondary analysis defined specific usage patterns mainly related to age and indication, with less of an effect based on the number of children.After decades of cryopreservation, the paradigm of sperm cryopreservation is mostly related to cancer patients. This should be reevaluated and evolve to include broader patient-targeted factors and perceptions.© 2023 The Authors. Andrology published by Wiley Periodicals LLC on behalf of American Society of Andrology and European Academy of Andrology.