Abstract
To compare the neonatal birthweight of singletons derived from ICSI cycles with fresh or frozen-thawed epididymal sperm in patients with obstructive azoospermia. A total of 436 singletons derived from ICSI cycles with fresh (n = 220) or frozen-thawed (n = 216) epididymal sperm in obstructive azoospermia evaluated from 2012 to 2018 in the retrospective study. Multivariate generalized linear model was used to analyze the association between epididymal sperm cryopreservation and neonatal birthweight. The crude birthweight and z-score in neonates derived from frozen-thawed epididymal sperm were significantly lower than those from fresh epididymal sperm (3186.57g vs 3303.61g and - 0.18 vs 0.08, respectively), with a mean difference of 117.04 (95% CI 32.36-201.72) g and 0.25 (95% CI 0.06-0.45). Adjusted for confounders including parental age and BMI, maternal ovarian reserve, paternal FSH and T levels, peak E2 during OPU cycles, frozen-thawed embryo transfer, embryo development stage, gestational age, maternal parity and child gender, the multivariate model suggested that singletons conceived from ICSI with fresh epididymal sperm was on average 91.21g heavier than those conceived from ICSI with frozen-thawed epdidiymal sperm (95% CI 12.72 to 166.7, P = 0.016). Cryopreservation of epididymal sperm may negatively affect birthweight.
Highlights
Azoospermia, characterized by a complete absence of sperm in the semen, occurs in approximately 5%-10% of infertile men and about 40% of azoospermia cases were diagnosed as obstructive [1, 2]
The aim of the study was to compare birthweight of neonates conceived from ICSI cycle using fresh and frozen-thawed epididymal sperm retrieved by percutaneous epididymal sperm aspiration (PESA)
We reviewed 1078 PESA-ICSI cycles, using either frozen-thawed (n=525) or fresh (n=553) epididymal sperm
Summary
Azoospermia, characterized by a complete absence of sperm in the semen, occurs in approximately 5%-10% of infertile men and about 40% of azoospermia cases were diagnosed as obstructive [1, 2]. The combination of surgical sperm retrieval and ICSI provides an effective therapy option for obstructive azoospermia, yielding comparable pregnancy outcomes than ICSI cycles using ejaculated sperm[3]. During ICSI cycles using epididymal or testicular sperm, cryopreservation of retrieved sperm during diagnostic procedure for ICSI has shown to be valid option to avoid repeating puncture or biopsy. The neonatal outcomes of children born after ICSI with epididymal/testicular sperm have been extensively reported[3, 9, 10], less is known about the effect of retrieved sperm cryopreservation on the neonatal outcomes of offspring. The aim of the study was to compare birthweight of neonates conceived from ICSI cycle using fresh and frozen-thawed epididymal sperm retrieved by percutaneous epididymal sperm aspiration (PESA)
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