Testicular sperm extraction and cryopreservation in patients with non-obstructive azoospermia prior to ovarian stimulation for ICSI|
Taha Abd Elnaser,Hamsa Rashwan
Objective: To compare between freshly retrieved and cryopreserved testicular sperm obtained from patients with non-obstructive azoospermia (NOA) undergoing intracytoplasmic sperm injection.
Design: Retrospective analysis of 168 TESE / ICSI cycles.
Setting: Adam international clinic. Giza, Egypt.
Materials and methods: One hundred sixty patients with documented NOA underwent microdissection TESE and either cryopreservation of the retrieved sperms (107) or concomittent ICSI at the same time (53), ICSI was planned later for the group who underwent crypoperservation. Comparison between the two groups in terms of fertilization, implantation, clinical pregnancy and abortion rates was done
Results: fifty four cycles were performed using freshly retrieved testicular sperm and 114 cycles were performed with cryo-thawed testicular sperms. The fertilization, implantation, pregnancy and abortion rates were 59.2%, 22%, 50% and 3.7% respectively for the first group versus 58.7%, 22% 45% and 16.3% for the second group respectively. No statistically significant differences were found in any of these parameters between the 2 groups (P > 0.05). Also, testicular histopathology did not affect ICSI outcome significantly between the 2 groups regardless of the degree of impairment of spermatogenesis.
Conclusion: cryo-thawed testicular sperm from NOA patients has the same fertilizing potential in ICSI programs, as the freshly retrieved sperm in those patients, TESE/cryopreservation has many advantages over TESE/ICSI in patients with NOA, So it should be considered as the first line in the therapy of those patients.
Cryopresevation, ICSI, non-obstructive azoospermia, TESE, testicular biopsy.