A comparison of ICSI outcomes with fresh and cryopreserved epididymal spermatozoa from the same couples

The published experience with frozen-thawed epididymal spermatozoa and intr acytoplasmic sperm injection (ICSI) suggests that fertilization and pregnan cy success rates are comparable to those achieved with freshly retrieved sp ermatozoa. However, no study has exactly compared clinical outcomes between the two IVF/ICSI cycles in the same couples. To formally address this issu e, we assessed ICSI outcomes in couples each of whom had had two IVF/ICSI c ycles: one using fresh and the second using frozen-thawed epididymal sperma tozoa obtained from a single aspiration procedure, From a pool of 101 conse cutive patients undergoing IVF/ICSI with epididymal spermatozoa, 19 couples initially used fresh epididymal spermatozoa and subsequently underwent a s econd:IVF/ ICSI procedure with frozen-thawed spermatozoa from the same aspi ration, Normal (2PN) oocyte fertilization rates, embryo quality and pregnan cy rates were compared between the two IVF/ICSI cycles for each couple. In the fresh epididymal sperm group, 58.4% of the injected oocytes fertilized normally compared with 62.0% of the injected oocytes in the frozen-thawed e pididymal sperm group, revealing no Statistically significant difference. G raded embryo quality also did not differ significantly between the paired I VF/ICSI cycles. The clinical pregnancy rates were 31.6% (6/19) and 36.8% (7 /19) in the first and second cycles respectively. All but one pregnancy wer e singletons, In summary, this study provides strong evidence to support th e notion that motile, cryopreserved and thawed epididymal spermatozoa are e qual to freshly retrieved spermatozoa for ICSI in couples with obstructive azoospermia.