REPRODUCTIVE & PERINATAL OUTCOMES OF FRESH VERSUS FROZEN TESTICULAR SPERM IN NON-OBSTRUCTIVE AZOOSPERMIA MEN

Abstract

To investigate Reproductive & Perinatal Outcomes of Fresh or Frozen-thawed surgically retrieved sperms (SRS) in Non-Obstructive Azoospermia (NOA) individuals Retrospective data Analysis of (n=108) patients undergoing SRS during January 2013 to June 2019.The study group was divided into two groups, Fresh SRS (n=60) and Frozen SRS (n=48) in our private IVF clinic. Study Design and Duration-Retrospective data Analysis of (n=108) patients undergoing SRS during January 2013 to June 2019.The study group was divided into two groups, Fresh SRS (n=60) and Frozen SRS (n=48) in our private IVF clinic. Inclusion-Couples undergoing Assisted Reproductive Technique (ART) cycles where the women were < 37 years old and male partners had NOA and had a successful retrieval of sperm, were included. Only self-gamete cycles were considered. Exclusion –Advanced maternal age (>38yrs), People with no sperm retrieval, People who did not have viable sperms after freezing and thawing. Women underwent controlled ovarian stimulation and oocyte retrieval (OPU) as per our clinic’s standard operating procedure (SOP). Male partner’s underwent SRS and testicular sperms were either used for ICSI if done at OPU or frozen and thawed for use in subsequent cycles as per SOP. Embryos cultured till blastocyst stage and freeze all policy was adopted. Couples underwent Frozen embryos transfers with two blastocysts and reproductive outcomes were evaluated. Primary Outcome- Blastocyst Rate (BR), Implantation Rate (IR), Live Birth Rate (LBR). Secondary Outcome-Fertilization Rate (FR), Miscarriage Rate (MR), Clinical Pregnancy Rate (CPR), Perinatal Outcomes. The Reproductive outcome for Fresh and Frozen Surgically Retrieved Sperms, respectively were, Fertilization Rate was 92.72 % v/s 92.74 % (p value 0.9968) Blastocyst Rate was 46.74 % v/s 35.57 % (p value 0.2444) Implantation Rate was 43.97 % v/s 47.27 %(p value 0.7334) Clinical Pregnancy Rate was 59.67 % v/s 73.33 % (p value 0.1390) Live Birth Rate was 45.16 % v/s 63.33 % (p value 0.0612) Miscarriage Rate was 4.84 % v/s 3.33 % (p value 0.6978) Perinatal Outcomes Both study groups had comparable perinatal outcomes with no concerning trends. Congenital anomalies - Only One baby from fresh SRS had Anglemans syndrome. There isn’t a marked difference in the outcomes between Fresh or Frozen SRS. Freezing testicular sperms doesn’t seem to alter reproductive and perinatal outcomes. Frozen Testicular Sperm seem to offer comparable outcomes with Fresh Testicular sperms in ART cycles. All trial attempts for sperm retrieval should be backed up with cryopreservation.