Diagnostic testicular biopsy and cryopreservation of testicular tissue as an alternative to repeated surgical openings in the treatment of azoospermic men

Between May 1996 and May 1998, 64 azoospermic patients underwent an investi gative testicular biopsy combined with the cryopreservation of spermatozoa which were retrieved from a simultaneously examined fresh sample. Testicula r tissue cryopreservation was carried out in 43 cases (67%) for late intrac ytoplasmic sperm injection (ICSI) attempts, In all, 23 couples underwent 26 assisted conception cycles; the fertilization rate was 64% with spermatozo a (139/218, 24 cycles), 40% with round spermatids (2/5, one cycle), and 69% with elongated spermatids (9/13, one cycle). The embryo cleavage rate was 84%, A mean number of 2.7 +/- 0.7 embryos were replaced in 24 patients, In two cases, embryo quality was very poor and they were not transferred. Eigh t clinical pregnancies resulted (35% per patient and 33% per transferred cy cle) with an implantation rate of 14.1%: two patients have already delivere d and six are ongoing. In conclusion, the cryopreservation of testicular ti ssue during the first diagnostic biopsy is an alternative to repeated surgi cal openings and permits patients to initiate an ovarian stimulation cycle with the certitude of having spermatozoa available, Moreover, since only on e straw is routinely used for each ICSI cycle, the frozen tissue remains as a sperm source for multiple attempts.