Quality of cryopreserved testicular sperm in patients with obstructive andnonobstructive azoospermia

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.