Frozen-thawed Testicular Sperm Research Articles

Pregnancy and neonatal outcomes of ICSI using pentoxifylline to identify viable spermatozoa in patients with frozen-thawed testicular spermatozoa.

Although the effectiveness of pentoxifylline (PF) as a selective inhibitor of phosphodiesterase to enhance sperm motility through increasing cyclic nucleotide in cases of absolute asthenozoospermia has been demonstrated for ICSI, data related to babies born from the PF-ICSI are still severely lacking. Concerns have been raised regarding the potential embryotoxicity of PF due to the controversial results obtained from the analysis of this compound on animal embryo development. This study aimed to determine whether the application of PF to trigger frozen-thawed TESA (testicular sperm aspiration) spermatozoa increases the risk of adverse obstetric and neonatal outcomes compared with non-PF frozen-thawed TESA ICSI and conventional ICSI using fresh ejaculation. A total of 5438 patients were analyzed in this study, including 240 patients underwent PF-TESA ICSI (ICSI using PF triggered frozen-thawed testicular spermatozoa), 101 patients underwent non-PF TESA ICSI (ICSI using frozen-thawed testicular spermatozoa) and 5097 patients underwent conventional ICSI using fresh ejaculation. Propensity score matching was executed to control the various characteristics of patients. No significant differences in pregnancy outcomes were observed among the three groups (PF-TESA ICSI, non-PF TESA ICSI and conventional ICSI), including biochemical pregnancy, clinical pregnancy, implantation, miscarriage, ectopic pregnancy, multiple pregnancy, and live birth, following propensity score matching. Additionally, neonatal outcomes were found to be similar among the three groups, with no statistical differences observed in the birth defect, birth weight, gestational age, preterm birth, and early-neonatal death. PF-ICSI may be an alternative treatment in patients using frozen-thawed testicular spermatozoa, resulting in comparable pregnancy and neonatal outcomes.

Outcomes of Microdissection Testicular Sperm Extraction/Intracytoplasmic Sperm Injection in Cases of Nonobstructive Azoospermia: A Retrospective Study

The outcomes and safety of intracytoplasmic sperm injection (ICSI) using testicular sperm have been controversial. We evaluated ICSI results, pregnancy outcomes, and neonatal health conditions using testicular sperm from patients with obstructive (OA) or nonobstructive (NOA) azoospermia. We further compared the ICSI outcomes after use of fresh versus cryopreserved testicular sperm from men with NOA. We included 314 men with NOA who underwent microdissection testicular sperm extraction (mTESE) and 303 with OA who underwent testicular sperm aspiration; both groups underwent ICSI. Therefore, 101 and 329 ICSI cycles were performed for mTESE and aspirated sperms, respectively. Furthermore, fresh and thawed embryos from both groups were transplanted to evaluate fertilization and pregnancy rates (NOA, 15 fresh and 123 thawed; OA, 59 fresh and 393 thawed). Finally, of the 101 ICSI cycles performed for NOA patients, 56 fresh-sperm cycles and 45 thawed-sperm cycles were performed to evaluate ICSI outcomes. Fertilization rates and two-pronuclear (2PN) fertilization rates were significantly lower in the NOA group than in the OA group. However, the 2PN cleavage rate, the high-quality embryo rate, the blastocyst formation rate, and the available blastocyst rate showed no significant intergroup differences. In addition, the pregnancy outcomes and neonatal health conditions were statistically similar. Finally, compared with thawed sperm, the fresh-sperm group had a higher 2PN fertilization rate and a higher high-quality embryo rate. However, blastocyst formation and available blastocyst rates were similar between the two groups. Patients with NOA achieved the same favorable results in embryo development, clinical pregnancy, and live birth capability as did OA patients. Neonatal conditions were not affected by type of azoospermia (NOA versus OA). For patients with NOA, fresh testicular sperm is superior to frozen-thawed testicular sperm in embryo development as evaluated at the cleavage stage, but we find no superiority evaluating at the stage of blastocyst formation.

Controversy over the use of Fresh Versus Frozen-Thawed Testicular Sperm in Men with Non-Obstructive Azoospermia Undergoing ICSI

Controversy over the use of Fresh Versus Frozen-Thawed Testicular Sperm in Men with Non-Obstructive Azoospermia Undergoing ICSI

Perinatal Outcomes of Babies Born with Fresh or Frozen-Thawed Testicular Sperm in Patients with Azoospermia

Aim: To compare the perinatal outcomes of pregnancies obtained with fresh or frozen-thawed sperm in patients who underwent surgical sperm extraction for the diagnosis of azoospermia. Materials and Methods: In this retrospective study, data were collected on couples who conceived following Intracytoplasmic Sperm Injection using surgically retrieved fresh or frozen-thawed sperm. Participants were divided into two equal groups as follows. Group 1 (n = 100) consisted of patients who underwent ICSI and subsequent embryo transfer using fresh testicular sperm and Group 2 (n = 100) consisted of patients who underwent ICSI by using frozen-thawed testicular sperm. Perinatal outcome was compared according to the use of fresh or frozen-thawed sperm. Primary outcome measures included clinical pregancy, miscarriage, live birth, congenital abnormality, birthweight, gestational age at delivery, stillbirth and neonatal death. Results: Live birth and clinical pregnancy rates were found to be significantly higher in patients who underwent ICSI/ET with frozen-thawed testicular sperm compared to fresh sperm group. The miscarriage rates were significantly lower in the frozen-thawed sperm group compared to the fresh testicular sperm group. Clinical pregnancy was detected in 18 cases, while no pregnancy was detected in 82 cases undergoing ICSI with fresh sperm. In the group where ICSI/ET was applied with frozen sperm, clinical pregnancy was detected in 51 cases, whereas pregnancy was not detected in 49 cases. In the frozen sperm group, in addition to C/S and multiple pregnancy rates, the number of babies with a birth weight below 2500 g was significantly higher than in the fresh sperm group. There was no significant difference between the groups in terms of minor and major congenital anomalies, birth weight, gestational age at delivery, stillbirth and neonatal death. Conclusion: Using fresh or frozen testicular sperm does not have a significant effect on perintal outcome in patients with azoospermia.

PGT or ICSI? The impression of NGS-based PGT outcomes in nonmosaic Klinefelter syndrome.

This retrospective study demonstrates the clinical outcomes of patients with nonmosaic Klinefelter’s syndrome (KS) who underwent preimplantation genetic testing (PGT) with frozen-thawed testicular spermatozoa. Microdissection testicular sperm extraction (micro-TESE) was performed for sperm retrieval. Next-generation sequencing (NGS) was conducted for embryo analysis. A total of 18 couples aged ≤35 years were included, and 22 oocyte retrieval cycles were completed. Euploidy was detected in 29 of 45 (64.4%) embryos. Additionally, the numbers of aneuploid and mosaic embryos detected were 8 (17.8%) and 8 (17.8%), respectively, regardless of a lack of sex chromosome abnormalities. Finally, 13 couples with euploid embryos completed 14 frozen embryo transfer (FET) cycles. Ten couples had clinical pregnancies, and 6 of them had already delivered 5 healthy babies and 1 monozygotic twin. There were also 4 ongoing pregnancies and 2 biochemical pregnancies, but no early pregnancy loss was reported. Based on our results, we speculate that for KS patients, when sperm can be obtained by micro-TESE, the cryopreservation strategy makes the ovarian stimulation procedure more favorable for female partners. The paternal genetic risk of sex chromosome abnormalities in their offspring is extremely low in men with KS. In addition to PGT, the intracytoplasmic sperm injection (ICSI) procedure is comparably effective but more economical for young nonmosaic KS couples. ICSI should be offered as an option for such couples, but monitoring by prenatal genetic diagnosis is recommended.

Intracytoplasmic sperm injection with fresh versus cryopreserved testicular sperm in azoospermic patients

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

Is genetic fatherhood within reach for all azoospermic Klinefelter men?

BackgroundMultidisciplinary management of Klinefelter cases is now considered good clinical practice in order to ensure optimal quality of life. Reproductive performance of Klinefelter men is an important issue however literature in this domain is limited and prone to bias.Study designThis was a retrospective longitudinal cohort study performed at a tertiary referral University Centre for Reproductive Medicine and Genetics. One hundred thirty-eight non-mosaic azoospermic Klinefelter patients undergoing their first testicular biopsy (TESE) between 1994 and 2013, followed by intracytoplasmic sperm injection (ICSI) with fresh or frozen-thawed testicular sperm in the female partner, were followed-up longitudinally. The main outcome measure was cumulative live birth rate per Klinefelter patient embarking on TESE-ICSI.FindingsIn forty-eight men (48/138) sperm were successfully retrieved at the first TESE (34.8%). The mean age of the patients was 32.4 years. Younger age at first TESE was associated with a higher sperm retrieval rate (p<0.001). Overall 39 couples underwent 62 ICSI cycles and 13 frozen embryo transfer cycles resulting in in 20 pregnancies and 14 live birth deliveries (16 children). The mean age of the female partner was 28.1 years. The crude cumulative delivery rate after four ICSI cycles was 35.9%. Per intention-to-treat however, only 10.1% (14/138) of the Klinefelter men starting treatment succeeded in having their biologically own child(ren).ConclusionNon-mosaic Klinefelter patients with azoospermia seeking treatment by TESE-ICSI should be counseled that by intention-to-treat the chance of retrieving sperm is fair, however only a minority will eventually father genetically own children.

MD-TESE-ICSI using fresh sperm resulted in a lower rate of miscarriage compared with frozen-thawed sperm

Purpose: Frozen-thawed embryo transfer achieves superior pregnancy and miscarriage rates compared with those achieved using fresh embryos, and there is no difference in fertilization rate using fresh versus frozen-thawed sperm collected by microdissection testicular sperm extraction (MD-TESE) when intracytoplasmic sperm injection (ICSI) is performed. However, there are few reports on the miscarriage rate using fresh versus frozen-thawed testicular sperm collected by MD-TESE. Materials and Methods: The present patient had been unable to conceive because of her husband’s azoospermia. Sperm was successfully collected via MD-TESE. ICSI using fresh or frozenthawed sperm was performed nine times. Results: Two fresh sperm ICSIs resulted in the delivery of two healthy babies. Seven frozen-thawed sperm ICSIs resulted in four pregnancies; however, three of these miscarried, and only one resulted in the delivery of a healthy baby. Conclusion: ICSI using fresh sperm decreased the rate of miscarriage compared with ICSI using frozen-thawed sperm in this patient.

Does cryopreservation of sperm affect fertilization in nonobstructive azoospermia or cryptozoospermia?

To compare intracytoplasmic sperm injection (ICSI) outcomes with the use of fresh or frozen-thawed ejaculated or testicular sperm in patients with cryptozoospermia or nonobstructive azoospermia. Retrospective cohort study. Tertiary medical center IVF unit. A total of 274 patients evaluated from 1999 to2011. A total of 103 patients underwent testicular sperm extraction (TESE) because of nonobstructive azoospermia, and 171 patients were diagnosed with cryptozoospermia. ICSI outcomes during the first cycle in each technique performed according to the sperm origin (testicular vs. ejaculated) and processing (frozen vs. fresh). Forty-eight cycles with the use of frozen testicular sperm, 22 cycles with fresh testicular sperm, 66 cycles with frozen ejaculated sperm, and 138 cycles with fresh ejaculated sperm were examined. Significantly more motile sperm were found in the fresh ejaculate group compared with the frozen-thawed ejaculate group (96% vs. 88%, respectively). Furthermore, fresh ejaculated sperm were found to have better fertilization rates than frozen ejaculated sperm (64% vs. 56%, respectively). No significant difference was found between fresh and frozen-thawed testicular sperm, either in motile sperm available for ICSI or in fertilization rate (64% vs. 62% and 52% vs. 49%, respectively). In cases of cryptozoospermia, frozen-thawed ejaculated sperm is inferior to fresh ejaculated sperm in fertilization rates. However, in nonobstructive azoospermia, no major differences were found between fresh and frozen-thawed testicular sperm. Therefore, uncoupled TESE/oocyte pick-up (OPU) should be considered in NOA cases to prevent possible unnecessary ovarian stimulation and OPU when no sperm cells are detected.

Retained fertilizing capability in cryopreserved feline spermatozoa.

Sperm cryopreservation offers a long-term preservation of male genetic materials for future assisted reproductive technologies. However, dramatic changes in temperature during freezing and thawing injure sperm cells. While motility is essential for AI and membrane integrity is crucial for in vitro fertilization (IVF), sperm DNA integrity is a common index of fertilizing capability required for AI, IVF and intracytoplasmic sperm injection (ICSI). In endangered felids died unexpectedly, attempts have been made to recover as many DNA intact spermatozoa as possible from epididymis and testis to increase the opportunity to produce offspring in future. Although sperm from caudal epididymis has shown retained fertilizing capability after freezing and thawing (27.3% conception rate after unilateral intrauterine insemination), sperm recovery from the corpus epididymis has been suggested as an alternative to increase the amount of preserved genetic materials. To improve epididymal sperm quality, pre-treatment with single-layer centrifugation resulted in selection of sperm cells with intact DNA while post-thaw treatment with extracellular ATP incubation promoted the blastocyst rate. Cold storage of domestic cat testis for 7days at 4°C demonstrated <1% of sperm cells with fragmented DNA. Moreover, isolated testicular sperm cells, stored for 7days at 4°C, produced after ICSI poorer percentages of cleavage, morula and blastocyst than the fresh control. In wild felids, a death-to-necropsy time of 2hr after a jungle cat (Felis chaus) aged 10years died during anaesthesia plus another necropsy-to-sperm recovery time of 25hr has been reported to yield the post-thawed testicular sperm with 22.2% intact DNA. In summary, the chromatin structure of feline ejaculated and epididymal sperm seems to be tolerated to cold storage and cryopreservation; thus, fertilizing capability is well protected. In contrast, the cat testicular sperm DNA is generally damaged through the cryopreservation.

In Vitro Fertilization Outcome After Intracytoplasmic Sperm Injection with Fresh and with Frozen-Thawed Epididymal Spermatozoa

&lt;p&gt;&lt;strong&gt;Introduction&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;Testicular epididymal sperm aspiration (TESA) is one of the method to retrieve sperm from the testes in men with azoospermia. The aim of the study is to compare the In vitro fertilization (IVF) outcome of intracytoplasmic sperm injection (ICSI)-ET cycles with fresh testicular epididymal spermatozoa obtained on the same day with oocyte retrieval and with frozen-thawed testicular epididymal spermatozoa.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Material &amp;amp; Methods&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;A retrospective comparative analysis of patients who underwent fresh TESA and frozen-thawed TESA in ICSI-ET cycles from January 2012 to December 2014 in Halim Fertility Center was done. Fresh testicular epididymal sperm aspiration (fresh TESA) was performed on the same day with oocyte retrieval in 28 cycles and the frozen-thawed testicular epididymal sperm aspiration (frozen-thawed TESA) was used in 30 cycles. &lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;The two groups were comparable in terms of the ages of male and female patients, etiology of infertility and duration of infertility. Fertilization rates in fresh TESA group were 53,5% and in frozen-thawed TESA group, fertilization rates were 50%. There was no statistically significant difference between the groups. Clinical pregnancy rates in fresh TESA group were 35,7% and in frozen-thawed TESA group, clinical pregnancy rates were 26,7% and statistically there was no significant difference between the groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion&lt;/strong&gt;&lt;/p&gt;There is no significant difference in the in vitro fertilization outcome of intracytoplasmic sperm injection (ICSI)-ET cycles between fresh TESA and frozen-thawed TESA .

Outcomes of ICSI cycles with either fresh or frozen-thawed testicular spermatozoa in consecutive cycles of non-obstructive azoospermic patients

To compare pregnancy outcomes of first ICSI cycles with fresh testicular spermatozoa in non-obstructive azoospermic patients with consecutive cycles, in whom frozen-thawed testicular spermatozoa were used one to three times during study period.

Impact of female age and ovarian reserve on the outcomes of ICSI cycles with either fresh or frozen-thawed testicular spermatozoa retrieved from non-obstructive azoospermic patients

To evaluate the influence of female age and ovarian reserve on the outcomes of ICSI cycles with either fresh or frozen-thawed testicular spermatozoa retrieved from non-obstructive azoospermic patients when compared to a large cohort who had undergone ICSI with either fresh or frozen-thawed ejaculated or aspirated sperm. This retrospective cohort study was conducted in a private IVF clinic between August 2011 and December 2015. A total of 550 non-obtructive azoospermic males underwent microdissection testicular sperm extraction (MicroTESE). Over a four-year period, some of the same couples applied for IVF and ICSI was performed using either testicular spermatozoa or frozen-thawed testicular spermatozoa, according to the clinical evaluation of the patients. In the same period 10086 couples applied for IVF and ICSI was performed with either fresh or frozen-thawed ejaculated or aspirated sperm. In the stated time-period, 248 and 150 embryo transfers were derived from fresh microTESE and frozen-thawed microTESE samples, respectively. A total of 8299 embryo transfers derived from either fresh or frozen-thawed ejaculated or aspirated sperm. Embryos were transferred either on day 3, 4 or 5 according to embryo development and the number of embryos to be transferred (one or two). Fourteen and sixteen days after pick-up, serum β-hCG was measured. At 7 weeks, a transvaginal ultrasound was performed to monitor early pregnancy. Clinical pregnancy was defined as fetal heart beat seen by transvaginal ultrasonography. No statistically significant differences were found between the microTESE and ejaculated/ aspirated sperm groups regarding the number of retrieved cumulus-oocyte complexes (COCs) for the five distinct categories (1-5; 6-10; 11-15; 16-20; >20). Clinical pregnancy rates (CPR) varied from 36.9 to 58.1% in the microTESE group for the first and last group, whereas CPR were of 34.35 and 47.7, in the same categories (p=0.59 and p=0.26, respectively). On the other hand, female age was causing a decrease of 4.5 to 6.5% in the CPR of the microTESE group when compared to the ejaculated/ aspirated sperm group for all age categories analyzed (<30; 30-34; 35-37; 38-40; 41-42 and 43≥). The trend in the age-dependent decline was significant (p=0.0158 and p<0.0001, respectively). The CPR was calculated as 56.1 and 50.8% in the ejaculated/ aspirated sperm group and microTESE group for <30 years of age, respectively. No significant differences were found between the ejaculated/ aspirated sperm group and microTESE group regarding CPR in all COC or female age categories. The female age-related decline was significant in both groups and was causing a 4.5 to 6.5% decline in the CPR of the microTESE group. Therefore, microTESE should not be regarded as a factor which aggravates IVF success rates once an embryo transfer could be planned.

Y-chromosome microdeletions in nonobstructive azoospermia and severe oligozoospermia.

The aim of the present work was to present the outcomes of the patients with Y-chromosome microdeletions treated by intracytoplasmic sperm injection (ICSI), either using fresh (TESE) or frozen-thawed (TESE-C) testicular sperm and ejaculated sperm (EJAC). The originality of this work resides in the comparisons between the different types of Y-microdeletions (AZFa, AZFb, and AZFc) and treatments, with detailed demographic, stimulation, embryological, clinical, and newborn (NB) outcomes. Of 125 patients with Y-microdeletions, 33 patients presented severe oligozoospermia (18 performed ICSI with ejaculated sperm) and 92 secretory azoospermia (65 went for TESE with 40 having successful sperm retrieval and performed ICSI). There were 51 TESE treatment cycles and 43 TESE-C treatment cycles, with a birth of 19 NB (2 in AZFa/TESE-C, 12 in AZFc/TESE, and 5 in AZFc/TESE-C). Of the 29 EJAC cycles, there was a birth of 8 NB (in AZFc). In TESE and EJAC cycles, there were no significant differences in embryological and clinical parameters. In TESE-C cycles, there was a significant lower oocyte maturity rate, embryo cleavage rate and mean number of embryos transferred in AZFb, and a higher mean number of oocytes and lower fertilization rate in AZFc. In conclusion, although patients with AZFc microdeletions presented a high testicular sperm recovery rate and acceptable clinical outcomes, cases with AZFa and AZFb microdeletions presented a poor prognosis. Due to the reported heredity of microdeletions, patients should be informed about the infertile consequences on NB and the possibility of using preimplantation genetic diagnosis for female sex selection.

Validation-verification of a highly effective, practical human testicular tissue in vitro culture-cryopreservation procedure aimed to optimize pre-freeze and post-thaw motility.

Purpose The aim of our paper was to validate a testicular biopsy procedure that simplifies handling, processing, and cryopreservation, while at the same time optimizes sperm motility before freezing and after thawing.MethodsTwo prospective studies were conducted to verify, optimize, and understand the virtues of pre-freeze testicular tissue IVC at different temperatures (21, 30, or 37 °C). Testicular tissue was obtained from clinical specimens designated for whole tissue cryopreservation (i.e., intact mass of tubules) and/or for fresh use in IVF-ICSI cycles. Whole testicular biopsy pieces (1–3 mm3) were diluted in glycerol containing freeze solutions, slow cooled to 4 °C and then rapidly frozen in LN2 vapor. Fresh and post-thaw testicular biopsy tissue were evaluated for changes in the quantity (%) and pattern of motility (I–IV: twitching to rapid progression, respectively) over a 1 week duration. The clinical effectiveness of IVC-cryopreserved whole testicular biopsy tissue was also validated analyzing fresh embryo transfers.ResultsMore reliable recovery of motile testicular sperm was achieved using whole tissue freeze preservation combined with IVC (24–96 h) post-acquisition at an incubation temperature of 30 °C compared to ambient temperature (21 °C) or 37 °C. Up to 85 % of the pre-freeze motility was conserved post-thaw (+3 h) for easy ICSI selection. Sperm longevity was optimized to fresh tissue levels by implementing testicular biopsy sucrose dilution post-thaw. Favorable clinical outcomes were proven using frozen-thawed testicular biopsy sperm for ICSI.ConclusionsBy employing minimal tissue manipulation, integrating pre-freeze IVC processing at 30 °C and the freezing of whole testicular biopsy tissue, we have reduced the labor and improved the efficacy of processing testicular tissue for freeze-preservation and subsequent ICSI use.

Clinical outcomes of intracytoplasmic sperm injection cycles with fresh-thawed or frozen-thawed testicular sperm from azoospermia patients

Clinical outcomes of intracytoplasmic sperm injection cycles with fresh-thawed or frozen-thawed testicular sperm from azoospermia patients

Intracytoplasmic sperm injection outcomes with cryopreserved testicular sperm aspiration samples.

Intracytoplasmic sperm injection (ICSI) may be performed with testicular frozen-thawed spermatozoa in patients with nonobstructive azoospermia (NOA). Sperm retrieval can be performed in advance of oocyte aspiration, as it may avoid the possibility of no recovery of spermatozoa on the day of oocyte pickup. There are few studies available in the literature concerning the use of frozen-thawed spermatozoa obtained from testicular sperm aspiration (TESA). To evaluate the effects and the outcomes of ICSI with frozen-thawed spermatozoa obtained by TESA, we performed a retrospective analysis of 43 ICSI cycles using frozen-thawed TESA. We obtained acceptable results with a fertilisation rate of 67.9%, an implantation rate (IR) of 17.1%, and clinical and ongoing pregnancy rates of 41.9% and 37.2% respectively. The results of this study suggest that performing ICSI using cryopreserved frozen-thawed testicular spermatozoa with TESA as a first option is a viable, safe, economic and effective method for patients with NOA.

Comparison of ART outcome between non-obstructive azoospermia and obstructive azoospermia: 15 years experiences

Comparison of ART outcome between non-obstructive azoospermia and obstructive azoospermia: 15 years experiences

Efficacy of cryopreservation of embryos generated by intracytoplasmic sperm injection with spermatozoa from frozen testicular tissue.

To evaluate the viability of frozen embryos generated by intracytoplasmic sperm injection (ICSI) with frozen testicular spermatozoa. A total of 68 fresh embryo transfer (ET) cycles and 85 subsequent frozen-thawed ET (FET) cycles were grouped according to the source of spermatozoa: fresh testicular spermatozoa (TESE) or frozen-thawed testicular spermatozoa (t-TESE). There were no significant differences in the age of female patients, number of oocytes, or fertilization rates in fresh ET cycles with TESE (TESE-fresh ET) versus t-TESE (t-TESE-fresh ET). The rate of embryo survival after thawing (95.7 % vs. 94.0 %) was similar in frozen ET cycles (FET) with TESE (TESE-FET) and with t-TESE (t-TESE-FET). While there were significant differences in the proportion of good quality embryos, no statistical differences were found in the pregnancy or clinical abortion rates between the two groups. Moreover, delivery rates were not significantly different. Although the proportion of good quality embryos was affected by cryopreservation of testicular tissue, embryo survival rate was not. As well, subsequent pregnancy could be achieved successfully via t-TESE-FET cycles. Therefore, FET is not affected by the cryopreservation of testicular tissue, and avoids further oocyte retrieval and TESE procedures.

Prognosis for patients using frozen testicular sperm and impact of maternal age

Limited data is available on clinical outcomes with frozen testicular sperm as many programs still prefer fresh biopsies. While presence of motile/ twitching sperm is linked to successful fertilization using frozen-thawed testicular sperm, few studies have looked at the impact of maternal age on final clinical outcomes. Such data may be a useful tool to improve patient counseling and manage expectations.