#360 : Twin Pregnancy After Step-Wise Cryopreservation and Thawing of Oocytes, Sperm and Blastocysts in the Case of Azoospermia: Case Report

Abstract

CASE: Although twins born from freeze-thawed mature oocytes were first reported in Australia in 1986, oocyte cryopreservation was experimental before 2012. The success of oocyte cryopreservation was uncertain compared to sperm freezing. Since then, many studies have been conducted on preserving female fertility, but data on the results of oocyte cryopreservation in the case of male infertility are limited. Thus, we aimed to report a twin pregnancy after three steps of cryopreservation, freezing, and thawing of oocytes, sperm, and blastocysts. At 40 years of age, a woman returned to our center, where donated sperm can be used by women with the desire to get pregnant. As her partner was diagnosed with severe oligospermia, she had already undergone eight cycles of OPU (Oocyte Pick Up), three times with fresh ET (Embryo Transfer), and three with thawed ET, but failed to get pregnant. With a diagnosis of recurrent implantation failure, she decided to cryopreserve oocytes for fertility preservation while waiting for her partner to improve his gamete condition. A total of 20 oocytes cryopreserved at three clinics were stored for that purpose. However, she decided to use sperm cryopreserved for donation after getting a urologic recommendation as a candidate for receiving donor sperm. Fourteen of 20 thawed oocytes survived (70%) and were inseminated by ICSI (Intracytoplasmic Sperm Injection) using thawed sperm. Twelve were fertilized (75%) and had started their development to become good embryos at three days (50%). Among five cryopreserved embryos, three were at the cleavage, and two were at the blastocyst stage. Two blastocyst embryos were thawed on the sixth day of progesterone treatment after pretreatment with estradiol valerate. Two gestational sacs were confirmed via ultrasound. This case is the first report of a successful pregnancy using cryopreserved oocytes, sperm, and blastocysts in Korea.