title: Improved in vitro fertilization embryo quality and pregnancy rates with intracytoplasmic sperm injection of sperm from fresh testicular biopsy samples vs. frozen biopsy samples.
abstract: OBJECTIVE
  To compare the outcomes of first-attempt IVF-intracytoplasmic sperm injection (ICSI) cycles when using fresh testicular biopsy samples vs. frozen biopsy samples.
  
  
  METHODS
  Retrospective chart review of 92 consecutive first-attempt IVF-ICSI cycles.
  
  
  METHODS
  Two IVF programs.
  
  
  METHODS
  Forty consecutive first-attempt IVF-ICSI patients using sperm from fresh testicular biopsy samples and 52 consecutive first-attempt IVF-ICSI cycles using frozen testicular biopsy samples.
  
  
  METHODS
  Testicular biopsy, IVF-ICSI with fresh and frozen-thawed spermatozoa.
  
  
  METHODS
  Fertilization rates, embryo quality, pregnancy, delivery, and spontaneous abortion rates.
  
  
  RESULTS
  A significantly increased ICSI fertilization percentage was obtained with frozen testicular biopsy samples (76.5% +/- 3.1%) vs. fresh biopsy samples (68.3% +/- 2.6%). However, embryo quality, pregnancy, and delivery rates were higher in the fresh biopsy group. Mean embryo score was 4.54 +/- 0.31 and 3.62 +/- 0.2 in the fresh vs. frozen group, respectively. Chemical pregnancy rates (60% vs. 49.1%), clinical pregnancy rates (56.4% vs. 41.2%), and delivery rates (48.7% vs. 31.2%) were each higher in the fresh group vs. frozen group. Accordingly, the spontaneous abortion rate was lower in the fresh group (21.7%) vs. the frozen group (33.3%).
  
  
  CONCLUSIONS
  Although the use of frozen biopsy samples has logistical advantages, we conclude it may be advantageous to use fresh testicular biopsy samples in IVF-ICSI cases whenever possible, as fresh specimens yielded significantly improved embryo quality, generally higher pregnancy rates, and lower spontaneous abortion rates.
authors.affiliation: Department of Surgery (Urology), University of Utah School of Medicine, Salt Lake City, Utah 84108, USA.
authors.forename: Vincent W
authors.initials: VW
authors.lastname: Aoki
authors.forename: Aaron L
authors.initials: AL
authors.lastname: Wilcox
authors.forename: Cindy
authors.initials: C
authors.lastname: Thorp
authors.forename: Blake D
authors.initials: BD
authors.lastname: Hamilton
authors.forename: Douglas T
authors.initials: DT
authors.lastname: Carrell
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D001706:Biopsy; D036861:Delivery, Obstetric; D004622:Embryo, Mammalian / Q000502:physiology*; D005260:Female; D005307:Fertilization in Vitro; D005615:Freezing; D006801:Humans; D015994:Incidence; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D013737:Testis / Q000473:pathology*; D020858:Tissue and Organ Harvesting / Q000379:methods*