title: Impact of fresh versus cryopreserved testicular sperm upon intracytoplasmic sperm injection pregnancy outcomes in men with azoospermia due to spermatogenic dysfunction: a meta-analysis.
abstract: OBJECTIVE
  To determine if clinical pregnancy rates and fertilization rates with the use of cryopreserved sperm for intracytoplasmic sperm injection (ICSI) in patients with azoospermia due to spermatogenic dysfunction (i.e., nonobstructive azoospermia) are similar to those with fresh sperm.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Azoospermic men secondary to spermatogenic dysfunction.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Clinical pregnancy rate, fertilization rate.
  
  
  RESULTS
  Eleven studies met criteria for the outcome of clinical pregnancy rate. Seventy-nine (28.7%) of 275 intracytoplasmic sperm injection cycles using fresh testicular sperm resulted in a clinical pregnancy, compared with 84 (28.1%) of 299 intracytoplasmic sperm injection cycles using cryopreserved sperm (relative risk [RR] 1.00, 95% confidence interval [CI] 0.75-1.33). Ten studies met criteria for the outcome of fertilization rate. A total of 1,422 (52.9%) of 2,687 oocytes injected with fresh testicular sperm were fertilized, compared with 1,490 (54.0%) of 2,757 oocytes injected with cryopreserved sperm (RR 0.97, 95% CI 0.92-1.02).
  
  
  CONCLUSIONS
  In men with azoospermia due to spermatogenic dysfunction, there is no statistical difference between the use of fresh versus cryopreserved-thawed testicular sperm when assessing clinical pregnancy or fertilization rates in couples undergoing ICSI.
authors.affiliation: University of Illinois, Chicago, Illinois. Electronic address: eisenberg@stanford.edu.
authors.forename: Samuel
authors.initials: S
authors.lastname: Ohlander
authors.affiliation: University of Illinois, Chicago, Illinois.
authors.forename: James
authors.initials: J
authors.lastname: Hotaling
authors.affiliation: University of Illinois, Chicago, Illinois.
authors.forename: Eric
authors.initials: E
authors.lastname: Kirshenbaum
authors.affiliation: University of Illinois, Chicago, Illinois.
authors.forename: Craig
authors.initials: C
authors.lastname: Niederberger
authors.affiliation: Stanford University, Stanford, California.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Eisenberg
mesh_terms: D053713:Azoospermia / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D015925:Cryopreservation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013091:Spermatogenesis / Q000502:physiology*; D013094:Spermatozoa / Q000502:physiology*
keywords: Nonobstructive azoospermia; cryopreservation; intracytoplasmic sperm injection