SUCCESSFUL FERTILIZATION, PREGNANCY, AND BIRTH USING EPIDIDYMAL SPERMFROZEN 24 HOURS AFTER CONVENTIONAL OOCYTE INSEMINATION

Objective: To assess if epididymal sperm cryopreserved 24 hours after exposure to oocytes in conventional IVF can be successfully used for i ntracytoplasmic sperm injection (ICSI) in a subsequent cycle. Design: Case report. Setting: University of California, Irvine, Center for Rep roductive Health. Patients: Two men with obstructive azoospermia requi ring microsurgical epididymal sperm aspiration, IVF, and ICSI. Interve ntions: Freezing of epididymal sperm 24 hours after egg exposure in co nventional IVF and subsequent use for assisted fertilization in a new cycle. Main Outcome Measure: Frozen-thawed epididymal sperm survivabil ity and maintenance of fertilization and pregnancy capacity. Results: At the time of sperm aspiration procedure (cycle I) a total of 30 oocy tes were available for insemination. Of these, 15 were used for conven tional IVF resulting in 2 embryos (13%) and 15 were used for ICSI, res ulting in 3 embryos (20%). Sperm was cryopreserved 24 hours after conv entional IVF and thawed 6 months later in a new cycle. Upon thawing, s perm were still found to be motile and at this time (cycle II) only as sisted fertilization was used. Of 27 oocytes injected, 12 (44%) produc ed normal, cleaving embryos. One singleton pregnancy with the birth of a healthy infant girl was achieved after the tubal transfer of 5 embr yos. Conclusion: The birth of a normal, healthy infant girl with epidi dymal sperm frozen 24 hours after exposure to oocytes in conventional IVF emphasizes the value of freezing any aliquot of epididymal sperm, even if the motility is very low, to avoid additional surgery in the m ale. From a basic science standpoint, this observation may renew inter est in the study of sperm cryopreservation after occurrence of acrosom e reaction and hyperactivation.