Abstract
Objective: Intracytoplasmatic sperm injection (ICSI) has improved fertilization and pregnancy rates in assisted reproduction programs. We studied the fertilization of cryopreserved oocytes with ICSI. Methods: A long protocol (GnRH analogues/FSH, hMG) was generally used for ovarian stimulation. Oocytes from 57 patients were cryopreserved using modified standard freezing and thawing protocols. 16 patients became pregnant after the first treatment cycle with native oocytes so that 31 remained for ICSI with cryopreserved oocytes. 38 cycles with cryopreserved oocytes were carried out in 26 of these patients. Results: After thawing 24 of 161 oocytes (15%) were degenerated. The degeneration rate after ICSI was a further 13%. Thus the total degeneration rate was higher than that with pronuclear stages (28% vs. 22%). 36 embryo transfers resulted in 7 clinical pregnancies. One pregnancy ended in spontaneous abortion, 2 in the delivery of healthy twins, and 4 are ongoing. Conclusion: Fertilization of cryopreserved oocytes by ICSI is associated with a good fertilization rate (48%) and a good pregnancy rate (24% per thawing cycle). The procedure is indicated if freezing of embryos or pronuclear stages is not an option. Furthermore, it appears to be a potential alternative for young patients scheduled for chemotherapy or radiation therapy.
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