EFFICACY OF INTRACYTOPLASMIC SPERM INJECTION USING INTENTIONALLY CRYOPRESERVED EPIDIDYMAL SPERMATOZOA

Microsurgical epididymal sperm aspiration was a great advance In the t herapy of patients with non-reconstructable, obstructive azoospermia, most notably congenital bilateral absence of the vas deferens. Using c onventional in-vitro fertilization, pregnancies were rarely achieved b ecause the rate of oocyte fertilization was extremely poor, However, t he use of retrieved spermatozoa in conjunction with intracytoplasmic s perm injection (ICSI) has dramatically increased the likelihood of emb ryo formation, Typically, sperm and oocyte harvesting are performed si multaneously, We have investigated whether frozen-thawed spermatozoa w ork as well as fresh spermatozoa, When we had concluded from our own p opulation of patients (groups I and II) that they did, we adopted a po licy of aspirating spermatozoa, primarily cryopreserving them and usin g them for ICSI at a later date, We found the fertilization rates of t his latter cohort of patients (group III) to be excellent (37% per ooc yte), and the ongoing pregnancy rate is quite satisfactory (40% per co uple, 29% per cycle), We offer this approach as an alternative to the traditional scheme because it markedly eases the burden of partner sch eduling on both the couple and the clinicians involved. In addition, a ssurance of the availability of male partner spermatozoa can be attain ed prior to beginning ovulation induction.