Cryptozoospermia: Should we use ejaculated sperm or surgically retrieved sperm for assisted reproductive technology?

Area of Science:

• Reproductive Medicine
• Andrology
• Infertility Research

Background:

• Cryptozoospermia presents challenges in obtaining motile sperm for assisted reproductive technology (ART).
• Conventional methods may struggle to secure sufficient sperm for procedures like intracytoplasmic sperm injection (ICSI).

Purpose of the Study:

• To evaluate the efficacy of ART using frozen-thawed ejaculated sperm in cryptozoospermic individuals.
• To determine if sperm retrieval surgery is necessary for these patients.

Main Methods:

• Retrospective analysis of 197 cryptozoospermic patients between 2013-2021.
• Cryopreservation of ejaculated motile sperm collected weekly over three months.
• ART outcomes including fertilization, pregnancy, and live birth rates were recorded.

Main Results:

• Assisted reproductive technology (ART) was successful using both frozen and fresh ejaculated sperm.
• A normal fertilization rate of 70.4% and a clinical pregnancy rate of 31.5% per embryo transferred were achieved.
• A live birth rate of 73.8% per case was observed.

Conclusions:

• Intracytoplasmic sperm injection (ICSI) is feasible without sperm retrieval surgery in cryptozoospermia.
• Careful sperm identification, processing, and ICSI technique are crucial for success.
• Sperm retrieval surgery can be successfully avoided in cryptozoospermic patients undergoing ART.