Gs. Prins et al., Quality of cryopreserved testicular sperm in patients with obstructive andnonobstructive azoospermia, J UROL, 161(5), 1999, pp. 1504-1508
Purpose: Sperm retrieved by testicular sperm extraction is routinely used t
o attempt pregnancy by in vitro fertilization-intracytoplasmic sperm inject
ion. We evaluated the efficacy of cryopreserving testicular sperm collected
by testicular sperm extraction at diagnostic biopsy.
Materials and Methods: A total of 73 men with obstructive and 42 with nonob
structive azoospermia underwent testicular sperm extraction at diagnostic b
iopsy. Sperm was retrieved and cryopreserved in all cases of obstruction an
d in 15 of nonobstructive azoospermia cases; Before freezing we determined
sperm count;, motility, morphology and viability, and after thawing we asse
ssed sperm motility and viability. In 17 couples a total of 20 cycles of in
vitro fertilization-intracyeoplasmic sperm injection were performed and fe
rtilization, cleavage and pregnancy rates were determined in cases of obstr
uction and nonobstruction.
Results: Sperm count and morphology were lower in the testicular biopsies o
f men with nonobstructive versus obstructive azoospermia. Motility was low
or absent in all testicular sperm extraction specimens. Importantly, pre-fr
eeze (63%) and post-thaw (31%) viability was the same in both patient group
s. After in vitro fertilization-intracytoplasmic sperm injection using froz
en and thawed testicular sperm the fertilization, cleavage, implantation an
d clinical pregnancy rates were 60, 86, 16 and 50%, respectively. Using cry
opreserved sperm we observed no differences in outcome of any in vitro fert
ilization-intracytoplasmic sperm injection procedure in patients with obstr
uctive versus nonobstructive azoospermia.
Conclusions: Cryopreservation of testicular sperm provides enough good qual
ity sperm after thawing to result in excellent in vitro fertilization-intra
cytsplasmic sperm injection outcomes. Cryopreservation does not adversely a
ffect intracytoplasmic sperm injection outcomes, including pregnancy rate.
Therefore, we recommend routine testicular sperm extraction and cryopreserv
ation of sperm at testicular biopsy.