Abstract
BackgroundThe purpose of this study is to compare the outcome of intracytoplasmic sperm injection (ICSI) using fresh sperm versus frozen-thawed sperm in both obstructed and non-obstructed azoospermias. This retrospective study included 159 ICSI cycles from 126 couples. In 91 obstructed azoospermia cases, 66 cycles were treated with fresh testicular sperm and 25 cycles were treated with frozen-thawed testicular samples. In 68 non-obstructed azoospermia cases, 32 cycles were treated with fresh testicular sperm and 36 cycles were treated with frozen-thawed testicular sperm, and the main measure and outcomes calculated are fertilization rate, clinical pregnancy, and live birth rate.ResultsIn case of obstructed azoospermia, there were no statistically significant differences between fresh sperm and frozen-thawed testicular sperm used for ICSI regarding fertilization rate, clinical pregnancy rate, and live birth rate as shown (57%, 47%, 0.093 p value; 23.7%, 17.4%, 0.54 p value; and 11.9%, 8.7%, 0.68 p value, respectively). Non-obstructed azoospermia cases also show no significant differences in fertilization rate (37%, 36%, 0.91 p value), clinical pregnancy rate (20%, 14.3%, 0.58 p value), and live birth rate (4%, 3.6%, 0.93 p value).ConclusionCryopreservation of testicular sperm is reliable if carried out before ovulation induction especially in cases with non-obstructive azoospermia
Highlights
The purpose of this study is to compare the outcome of intracytoplasmic sperm injection (ICSI) using fresh sperm versus frozen-thawed sperm in both obstructed and non-obstructed azoospermias
Intracytoplasmic injection with testicular sperm since its introduction in 1993 [1, 2] has become a routine treatment procedure for patients with azoospermia, whether they suffer from obstructive azoospermia (OA), which is defined as the absence of spermatozoa in the ejaculate despite normal spermatogenesis (OA is a common urologic condition and accounts for 6.1% [1] to 13.6% [2] of patients presenting for fertility evaluation [3, 4]), or nonobstructive azoospermia (NOA) which is defined as no sperm in the ejaculate due to failure of spermatogenesis and is the most severe form of male infertility
The aim of our study is to present our data on ICSI cycles using surgically retrieved sperm from azoospermic men, to assess embryo development, and to compare the outcomes of ICSI for fresh sperm versus frozen-thawed testicular sperm in both OA and NOA
Summary
The purpose of this study is to compare the outcome of intracytoplasmic sperm injection (ICSI) using fresh sperm versus frozen-thawed sperm in both obstructed and non-obstructed azoospermias. This retrospective study included 159 ICSI cycles from 126 couples. In 91 obstructed azoospermia cases, 66 cycles were treated with fresh testicular sperm and 25 cycles were treated with frozen-thawed testicular samples. In 68 non-obstructed azoospermia cases, 32 cycles were treated with fresh testicular sperm and 36 cycles were treated with frozenthawed testicular sperm, and the main measure and outcomes calculated are fertilization rate, clinical pregnancy, and live birth rate. Repeated testicular surgery in subsequent ICSI cycles may cause testicular devascularization and possibly permanent injury [14, 15]
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