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Does cryopreservation of sperm affect fertilization in nonobstructive azoospermia or cryptozoospermia?
Natali Schachter-Safrai1, Gilad Karavani2, Eliahu Levitas1
1Fertility and IVF Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center, Beer Sheva, Israel; Faculty of Health Science, Ben Gurion University of the Negev, Beer Sheva, Israel.
Fertility and Sterility
|April 11, 2017
Summary
For cryptozoospermia, fresh ejaculated sperm yields better fertilization than frozen sperm. In nonobstructive azoospermia, fresh and frozen testicular sperm show similar intracytoplasmic sperm injection (ICSI) outcomes, suggesting uncoupled procedures.
Area of Science:
- Reproductive Medicine and Urology
- Assisted Reproductive Technologies (ART)
Background:
- Intracytoplasmic sperm injection (ICSI) is a key technique in assisted reproduction.
- Sperm source (ejaculated vs. testicular) and processing (fresh vs. frozen) can impact ICSI success rates.
- Patients with cryptozoospermia or nonobstructive azoospermia (NOA) present unique challenges for sperm retrieval.
Purpose of the Study:
- To compare intracytoplasmic sperm injection (ICSI) outcomes using fresh or frozen-thawed ejaculated sperm versus testicular sperm.
- To evaluate outcomes in patients diagnosed with cryptozoospermia or nonobstructive azoospermia (NOA).
Main Methods:
- Retrospective cohort study of 274 patients undergoing ICSI between 1999 and 2011.
- Analysis of ICSI outcomes based on sperm origin (testicular vs. ejaculated) and processing (fresh vs. frozen-thawed).
- Included 103 patients with NOA undergoing testicular sperm extraction (TESE) and 171 patients with cryptozoospermia.
Main Results:
- Fresh ejaculated sperm showed significantly higher fertilization rates (64%) compared to frozen-thawed ejaculated sperm (56%).
- No significant difference in motile sperm availability or fertilization rates was observed between fresh (64%) and frozen-thawed (62%) testicular sperm.
- Fresh ejaculated sperm had a higher proportion of motile sperm (96%) than frozen-thawed ejaculated sperm (88%).
Conclusions:
- Frozen-thawed ejaculated sperm is less effective for fertilization in cryptozoospermia cases compared to fresh sperm.
- Fresh and frozen-thawed testicular sperm yield comparable ICSI outcomes in nonobstructive azoospermia (NOA).
- Uncoupled testicular sperm extraction (TESE) and oocyte retrieval (OPU) are recommended for NOA patients to optimize procedures and avoid unnecessary stimulation.