Frequently asked questions

How does chemotherapy affect fertility and sperm health?

Chemotherapy kills cells that divide quickly. This targets cancer cells, but inadvertently affects sperm cells as well. Some chemo drugs may halt sperm production and cause azoospermia within 3 months, while others can reduce sperm motility. Chemo can also damage germ cells and affect sperm production in children. Finally, chemotherapy is likely to damage the DNA carried by sperm.

Depending on the drug you receive and the dose, sperm production may resume in 15 to 49 months. If chemo damages all the stem cells in the testicles that make new sperm, infertility may be permanent.

How can I use my frozen sperm in the future?

You can use your frozen sperm in an intrauterine insemination (IUI) or in vitro fertilization (IVF) procedure. Generally speaking, one vial of sperm is used in each IUI or IVF procedure.

1 semen sample = 4 vials of frozen sperm

1 vial of frozen sperm = 1 IUI or IVF procedure

I already started taking testosterone. Is it too late to freeze my sperm?

Not necessarily. It takes time for testosterone replacement therapy to affect your fertility. The quantity and quality of sperm may deteriorate progressively the longer you’ve been taking TRT, and you’ll typically see a significant decrease in fertility or complete sterility after about 4 months of TRT.

If you’re already taking testosterone, we recommend starting with a semen analysis. This test will assess the quality of your semen and determine whether your sample is viable for freezing.

If you do a semen analysis with Legacy and have viable sperm, you can upgrade your purchase to include freezing, and freeze that sample immediately.

If you don’t have viable sperm, you can consider pausing your TRT for 3–6 months to see if sperm production resumes before continuing with the fertility preservation process.

Will my fertility return if I stop taking TRT?

Maybe. The “sperm cycle” — how long it takes to produce new sperm — is about 3 months, so you will likely have to pause hormone therapy for at least this long in order to recover fertility. One study found that within 6 months of stopping testosterone therapy, 67% of subjects regained a normal sperm count. That means about 1 of every 3 people on testosterone may be unable to recover their fertility.

Will my fertility be protected if I take hCG along with TRT?

Possibly. Without getting too technical, hCG mimics the effect of another reproductive hormone, luteinizing hormone (LH). LH is essential to the production of sperm, and LH levels drop significantly for men on TRT. Therefore, taking hCG can help maintain sperm production in those who are taking testosterone. One small study found that hCG helped maintain sperm production for at least a year of TRT.

However, it’s impossible to know how hormone therapy will impact you. Even if you’re taking hCG alongside testosterone, we highly recommend sperm freezing as a back-up plan, especially if you’re certain you want kids in the future.

How will other protocols to increase testosterone (i.e. Clomid) affect my fertility?

If you’re not taking actual testosterone, it’s less likely that your medication will negatively affect your sperm production. For example, Clomid (clomiphene citrate) is a medication that has been shown to increase testosterone levels and improve fertility for some men.

If you’re unsure about how your medication will impact fertility, talk to your doctor or schedule a call with one of our fertility advisors.

How will testosterone replacement therapy (TRT) affect my fertility?

Many people believe that testosterone contributes to fertility, and that testosterone therapy may even improve fertility. However, taking external testosterone can throw off the balance of other reproductive hormones that actually drive sperm production.

As a result, TRT is likely to cause impaired fertility or complete infertility. One study found that 65% of men on TRT become temporarily sterile within 4 months of use.

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How much does shipping cost?

Pricing & payment

Standard shipping (3–5 business days) is free on all Legacy purchases.

Expedited shipping (1–2 business days) is available for a $35 fee. For an order with multiple kits (such as a For Tomorrow or Forever bundle), expedited shipping applies only to the first kit.

My kit didn't arrive by the estimated delivery date. Can I get a refund?

Troubleshooting

Estimated delivery dates are not guarantees. We ship expedited orders as soon as possible and partner with leading carriers for expedited shipping. However, delays may occur due to factors outside our control. We cannot provide a refund or cancellation of your purchase or your expedited shipping fee if your kit does not arrive by the estimated delivery date.

For an order with multiple kits (such as a For Tomorrow or Forever bundle), expedited shipping applies only to the first kit.

How fast are Legacy kits shipped?

Process & kit components

Legacy offers two shipping options: standard shipping (3–5 business days) and expedited shipping (1–2 business days) for an additional fee of $35.

For an order with multiple kits (such as a For Tomorrow or Forever bundle), expedited shipping applies only to the first kit.

What’s the difference between insurance coverage, FSA/HSA, and fertility benefits programs?

Health insurance, typically offered by employers in the US, is a plan that provides financial coverage for some or all of your necessary healthcare expenses.

Flexible spending accounts (FSA) and health savings accounts (HSA) are additional employer-sponsored benefits. These accounts allow you to save tax-free or tax-deductible funds for eligible healthcare expenses.

Fertility benefits programs are separate, additional insurance or coverage plans that may bridge the gap in fertility coverage in traditional insurance plans. These plans may offer specific coverage, discounts, or funds for fertility care such as diagnostic tests, infertility treatment, and fertility preservation (like sperm freezing).

Examples of fertility benefits providers include:

Carrot

Progyny

Maven

WINFertility

The best way to understand if you have access to fertility benefits is to talk to your employer.

Can I use my FSA or HSA to pay for Legacy’s products or services?

Yes. Certain Legacy products and services are eligible for reimbursement via flexible spending accounts (FSA) and health savings accounts (HSA).

What may be eligible:

Semen analysis

Temporary frozen sperm storage

If you plan to submit your purchase for reimbursement from an FSA or HSA, please contact us for an itemized FSA/HSA receipt. Email us at clientservices@givelegacy.com.

What if I paid for my Legacy products or services out of pocket — can I submit to my insurance for reimbursement?

If you already purchased a Legacy kit or bundle on your own, the easiest way to get reimbursed by your insurance or benefits plan is to submit an itemized insurance receipt. Then, your insurance will reimburse you directly for the covered costs.

To get an itemized insurance receipt, please email us at receipts@givelegcy.com.

What if my insurance plan requires prior authorization or another process to demonstrate medical necessity?

Prior authorization is a process by which your insurance provider approves care in advance. Some plans require prior authorization, or a similar process, to assess medical necessity before they’ll cover a claim.

Legacy is not your medical provider, and does not have access to your medical history, records, or documentation. Therefore we cannot provide evidence of medical necessity or complete prior authorization requests.

If your plan requires prior authorization, we recommend that you see your own physician and discuss at-home semen analysis and sperm freezing with Legacy. Your doctor can submit the information required for prior authorization digitally.

What will I owe if I use my insurance, and when?

You can check your insurance plan’s explanation of benefits, typically mailed to you or available online, to understand whether fertility testing and preservation services will be covered, and if a deductible, copay, or coinsurance will apply. Your explanation of benefits should also specify if prior authorization is required for your plan.

Alternatively, you can call the Member hotline found on the back of your insurance card. Due to regulations around provider-plan communication, we can’t make this call for you.

Keep in mind that you’ll be responsible for any charges that are not covered by your insurance plan or fertility benefits (up to the full cost of the services purchased, or $540). Typically, claims are processed and fees assessed by insurance providers within 2 months.

The CPT® or procedure codes associated with Legacy’s testing and freezing services include:

89320 Semen analysis

89259 Cryopreservation, sperm

89343 One year storage, sperm

89353 Thawing cryopreserved sperm

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Will my sperm testing/freezing be 100% covered by insurance?

By using this insurance eligibility tool, you’re able to check if Legacy is in-network with your plan. However, we are not able to confirm that your insurance plan will cover 100% of the fees associated with sperm testing and freezing.

Your specific insurance plan may include:

A deductible: An out-of-pocket cost you need to pay before your insurance will cover services.

A copay or coinsurance: A flat- or percentage-based fee assessed by your insurance plan on specific medical services.

Additionally, fertility diagnostic testing and fertility preservation may be considered a non-covered service by some insurance plans.

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Which Legacy products and services are covered by insurance or fertility benefits?

Most eligible insurance plans cover a “For Today” semen analysis kit plus one year of frozen sperm storage. Your insurance or benefits plan may cover additional testing or storage. Check your explanation of benefits document for clarity.

Which insurance does Legacy accept?

Legacy is in-network with several leading insurance providers, including:

Aetna

Cigna

EmblemHealth

TriWest

UnitedHealthcare

Your specific plan’s coverage will depend on your location and benefits details.

You may also want to explore coverage from fertility benefits programs offered by some employers. Legacy’s products and services may be covered by benefits from:

Carrot

Progyny

Maven

WINFertility

Not sure if you have access to these benefits? Ask your employer! The details of your coverage will depend on which plan is offered by your employer.

When should I test/freeze my sperm?

Sperm freezing

Sperm testing

Ideally, members of the military will test and/or freeze prior to deployment, as deployment exposures and health impacts may negatively affect sperm health. Intense physical exercise and lack of sleep can also negatively affect sperm quality; for that reason, Department of Defense officials also recommend at least 6 weeks’ wait between combat training, including boot camp or hell week, and producing a sample for analysis or freezing.

What’s included with Legacy’s at-home sperm testing & freezing kit?

Process & kit components

The Legacy kit includes:

The Legacy “vault,” an insulated zippered container that maintains a stable temperature during transportation.
A sterile sample cup to easily collect your sample from home.
The sperm transport liquid — a vial of pink fluid — to keep your sample viable during shipping.
A security padlock to seal the vault + a strip of tamper-proof tape for extra security.
Free overnight shipping to send your sample to our lab for analysis.
Access to Legacy’s client dashboard, where you’ll be able to see your results, where your sample is frozen, and more.

The Standard & Advanced Semen Analysis options also include lifetime access to our Insights dashboard, including your Sperm Score and a comparison of your metrics against thousands of clients your age.

How does testing & freezing my sperm work with Legacy?

Process & kit components

Order a sample collection kit. We'll ship it to your home.
Collect the sample at home following the instructions with your kit.
Ship the kit back to our lab with the included overnight shipping label.
Our lab will analyze your sample. Test results are sent securely to your online client dashboard within 48 hours.
If you chose a freezing plan, we’ll freeze your sample and send it to long-term storage.

See more details on.

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Will I owe a deductible or co-insurance payment?

Pricing & payment

We are not able to confirm that your insurance plan will cover 100% of the fees associated with sperm testing and freezing. Your specific TRICARE plan may include:

A deductible: An out-of-pocket cost you need to pay before your insurance will cover services.
A copay or coinsurance: A flat- or percentage-based fee assessed by your insurance plan on specific medical services.

You’ll be responsible for any charges that are not covered by your insurance plan or fertility benefits (up to the full cost of the services purchased, or $440). Typically, claims are processed and fees assessed by insurance providers within 2 months. You will be notified of any outstanding balances/fees when the claim is processed.

Do I need a referral?

Pricing & payment

TRICARE Prime policies typically require a referral from a physician for coverage, while TRICARE Select policies do not. See your personal explanation of benefits for details.

I get care through the VA. Am I covered for Legacy services?

Military & Veterans

Legacy is in-network with VA Community Care networks nationwide, and at-home sperm testing and freezing is covered by Veterans’ benefits. If you get benefits through the VA, your team can use our NPI — 1366068454 — to generate an authorization and a standardized episode of care (SEOC). Email us at insurance@givelegacy.com for more information.

Who do I contact if I have questions?

Process & kit components

For any questions about our products or the process, you can contact our client services team at clientservices@givelegacy.com or 617-514-0901.

Frequently asked questions

Don’t leave family to chance.