Influence of motility on the outcome of in vitro fertilization/intracytoplasmic sperm injection with fresh vs. frozen testicular sperm from men with obstructive azoospermia.
OBJECTIVE
To assess the efficacy of fresh vs. frozen testicular sperm on fertilization and pregnancy using intracytoplasmic sperm injection.


METHODS
Retrospective study.


METHODS
Hospital-based infertility research laboratory.


METHODS
One hundred sixty patients with obstructive azoospermia undergoing testicular sperm extraction (TESE).


METHODS
Sections of seminiferous tubule were cryopreserved after TESE. Sperm motility and fertilizing ability were determined after thawing seminiferous tubule sections.


METHODS
Sperm motility and optimal fertilization and pregnancy rate.


RESULTS
Intracytoplasmic sperm injection was performed using fresh testicular sperm (fresh-sperm group; 84 cases) and thawed seminiferous tubules (thawed-sperm group; 177 cases). The overall fertilization rate was 65.4%, and the pregnancy rate was 34.0%. In the fresh-sperm group, the fertilization rate was 70.9%, and the pregnancy rate was 38.8%. In the thawed-sperm group, the fertilization rate was 62.7%, and the pregnancy rate was 21.7%. Fertilization rates were higher using fresh motile sperm vs. nonmotile sperm (77.0% vs. 29.3%). Pregnancy rates were higher using fresh motile sperm vs. nonmotile sperm (44.3% vs. 20.0%). The fertilization and pregnancy rates of motile vs. nonmotile sperm extracted from the thawed seminiferous tubule were 70.0% vs. 50.9% and 33.9% vs. 27.3%, respectively. Motile spermatozoa could be obtained several hours after thawing in most of the cases.


CONCLUSIONS
Optimal fertilization and pregnancy rates were achieved using fresh vs. frozen sperm obtained using TESE when motile sperm were identified. Motile spermatozoa provided superior results to nonmotile sperm and are necessary for optimal fertilization and pregnancy outcomes.
Park
Yong-Seog
YS
Laboratory of Reproductive Biology and Infertility, Samsung Cheil Hospital and Women's Healthcare Center, Seoul, South Korea.
Lee
Sun-Hee
SH
Song
Sang Jin
SJ
Jun
Jin Hyun
JH
Koong
Mi Kyoung
MK
Seo
Ju Tae
JT
D000328:Adult; D015925:Cryopreservation; D005260:Female; D005306:Fertilization; D005307:Fertilization in Vitro; D006801:Humans; D008297:Male; D009845:Oligospermia / Q000503:physiopathology*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D012662:Semen Preservation; D012671:Seminiferous Tubules; D020554:Sperm Injections, Intracytoplasmic; D013081:Sperm Motility; D013094:Spermatozoa / Q000502:physiology*; D013737:Testis; D020858:Tissue and Organ Harvesting