Intracytoplasmic injection of fresh and cryopreserved testicular spermatozoa in patients with nonobstructive azoospermia--a comparative study.
OBJECTIVE
To compare the outcome of intracytoplasmic sperm injection (ICSI) with fresh and frozen-thawed testicular spermatozoa in patients with nonobstructive azoospermia.


METHODS
Retrospective analysis of consecutive ICSI cycles.


METHODS
In Vitro Fertilization Unit, Assaf Harofeh Medical Center.


METHODS
Eighteen with nonobstructive azoospermia in whom testicular sperm was found after testicular sperm extraction.


METHODS
Testicular sperm retrieval, cryopreservation, and ICSI with fresh or frozen-thawed testicular spermatozoa.


METHODS
Two-pronuclear fertilization; embryo cleavage rates, mean number of embryos transferred per cycle, and their relative quality, embryo implantation, clinical pregnancy, and ongoing pregnancy rates (PRs) per ET.


RESULTS
No statistically significant differences were noted in all parameters examined between ICSI cycles with fresh or cryopreserved testicular spermatozoa from the same nine patients and comparing all ICSI cycles performed; with fresh (25 cycles) and thawed (14 cycles) testicular spermatozoa, respectively: two-pronuclear fertilization, 47% versus 44%; embryo cleavage rates, 94% versus 89%; implantation rates, 9% versus 11%; and clinical PR, 26% versus 27%. The delivery or ongoing PR using fresh sperm was better (21% versus 9%), but the difference did not reach statistical significance. The cumulative clinical PRs and ongoing PRs per testicular sperm extraction procedure were 36% and 24%, respectively.


CONCLUSIONS
Testicular sperm cryopreservation using a simple freezing protocol is promising in patients with nonobstructive azoospermia augmenting the overall success achieved after surgical sperm retrieval.
Friedler
S
S
Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel.
Raziel
A
A
Soffer
Y
Y
Strassburger
D
D
Komarovsky
D
D
Ron-el
R
R
D000328:Adult; D002970:Cleavage Stage, Ovum; D015925:Cryopreservation; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D008297:Male; D008845:Microinjections; D009845:Oligospermia; D011247:Pregnancy; D011256:Pregnancy Outcome; D012662:Semen Preservation; D013094:Spermatozoa / Q000502:physiology*; D013737:Testis / Q000166:cytology*