INTRACYTOPLASMIC INJECTION OF FRESH AND CRYOPRESERVED TESTICULAR SPERMATOZOA IN PATIENTS WITH NONOBSTRUCTIVE AZOOSPERMIA - A COMPARATIVE-STUDY

Objective: To compare the outcome of intracytoplasmic sperm injection (ICSI) with fresh and frozen-thawed testicular spermatozoa in patients with nonobstructive azoospermia. Design: Retrospective analysis of co nsecutive ICSI cycles. Setting: In Vitro Fertilization Unit, Assaf Har ofeh Medical Center. Patient(s): Eighteen with nonobstructive azoosper mia in whom testicular sperm was found after testicular sperm extracti on. Intervention(s): Testicular sperm retrieval, cryopreservation, and ICSI with fresh or frozen-thawed testicular spermatozoa. Main Outcome Measure(s): Two-pronuclear fertilization; embryo cleavage rates, mean number of embryos transferred per cycle, and their relative quality, embryo implantation, clinical pregnancy, and ongoing pregnancy rates ( PRs) per ET.Result(s): No statistically significant differences were n oted in all parameters examined between ICSI cycles with fresh or cryo preserved testicular spermatozoa from the same nine patients and compa ring all ICSI cycles performed; with fresh (25 cycles) and thawed (14 cycles) testicular spermatozoa, respectively: two-pronuclear fertiliza tion, 47% versus 44%; embryo cleavage rates, 94% versus 89%; implantat ion rates, 9% versus 11%; and clinical PR, 26% versus 27%. The deliver y or ongoing PR using fresh sperm was better (21% versus 9%), but the difference did not reach statistical significance. The cumulative clin ical PRs and ongoing PRs per testicular sperm extraction procedure wer e 36% and 24%, respectively. Conclusion(s): Testicular sperm cryoprese rvation using a simple freezing protocol is promising in patients with nonobstructive azoospermia augmenting the overall success achieved af ter surgical sperm retrieval. (C) 1997 by American Society for Reprodu ctive Medicine.