Fertilization and pregnancy using cryopreserved testicular sperm for intracytoplasmic sperm injection with azoospermia.
OBJECTIVE
To report fertility for men with obstructive (OA) and nonobstructive (NOA) azoospermia after frozen and thawed spermatozoa recovered from the seminiferous tubules and intracytoplasmic sperm injection (ICSI) and to evaluate the factors other than spermatozoa.


METHODS
Retrospective clinical analysis.


METHODS
Male infertility clinic for testicular sperm extraction and freezing/thawing (cryoTESE) and assisted reproductive technologies clinic for ICSI.


METHODS
Seventy-four men with OA and 140 men with NOA undergoing attempted cryoTESE-ICSI.


METHODS
Seventy-three couples with OA underwent a total of 184 cryoTESE-ICSI cycles, and 46 couples with NOA underwent a total of 75 cryoTESE-ICSI cycles.


METHODS
The numbers of eggs at metaphase II injected, two-pronuclei oocytes, normal cleaved embryos, embryos transferred, transfer cycles, biochemical pregnancies, and clinical pregnancies, as well as the implantation and delivery rates, were examined.


RESULTS
Fertilization rate in NOA was significantly lower than in OA. Neither the pathology, the source, nor the quantity of spermatozoa had any effect on fertilization or pregnancy rates. Maternal age had no effect on fertilization or embryo cleavage, but did dramatically affect the implantation, pregnancy, and delivery rates in NOA and OA.


CONCLUSIONS
Good pregnancy rates were achieved without significant differences among the sperm sources. The pregnancy and the delivery rate were dependent strictly on the age of the female partner but not on her ovarian reserve.
Ishikawa
Tomomoto
T
Division of Urology, Department of Organs Therapeutics, Faculty of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, Japan. iskwtmmt@med.kobe-u.ac.jp
Shiotani
Masahide
M
Izumi
Yoko
Y
Hashimoto
Hiromi
H
Kokeguchi
Shoji
S
Goto
Sakae
S
Fujisawa
Masato
M
D000328:Adult; D053713:Azoospermia / Q000145:classification / Q000503:physiopathology*; D018929:Cell Culture Techniques / Q000379:methods; D015925:Cryopreservation / Q000379:methods*; D004624:Embryo Transfer; D005260:Female; D005306:Fertilization / Q000502:physiology*; D006801:Humans; D008297:Male; D009865:Oocytes / Q000166:cytology / Q000502:physiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012662:Semen Preservation / Q000379:methods*; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013084:Sperm-Ovum Interactions / Q000502:physiology; D013094:Spermatozoa / Q000166:cytology*