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Successful fertilization, pregnancy, and birth using epididymal sperm frozen 24 hours after conventional oocyte
P Patrizio1, T Ord, J P Balmaceda
1Department of Obstetrics and Gynecology, University of California, Irvine Medical Center, Orange, USA.
Objective:
To assess if epididymal sperm cryopreserved 24 hours after exposure to oocytes in conventional IVF can be successfully used for intracytoplasmic sperm injection (ICSI) in a subsequent cycle.
Design:
Case report.
Setting:
University of California, Irvine, Center for Reproductive Health.
Patients:
Two men with obstructive azoospermia requiring microsurgical epididymal sperm aspiration, IVF, and ICSI.
Interventions:
Freezing of epididymal sperm 24 hours after egg exposure in conventional IVF and subsequent use for assisted fertilization in a new cycle.
Main Outcome Measure:
Frozen-thawed epididymal sperm survivability and maintenance of fertilization and pregnancy capacity.
Results:
At the time of sperm aspiration procedure (cycle I) a total of 30 oocytes were available for insemination. Of these, 15 were used for conventional IVF resulting in 2 embryos (13%) and 15 were used for ICSI, resulting in 3 embryos (20%). Sperm was cryopreserved 24 hours after conventional IVF and thawed 6 months later in a new cycle. Upon thawing, sperm were still found to be motile and at this time (cycle II) only assisted fertilization was used. Of 27 oocytes injected, 12 (44%) produced normal, cleaving embryos. One singleton pregnancy with the birth of a healthy infant girl was achieved after the tubal transfer of 5 embryos.
Conclusion:
The birth of a normal, healthy infant girl with epididymal sperm frozen 24 hours after exposure to oocytes in conventional IVF emphasizes the value of freezing any aliquot of epididymal sperm, even if the motility is very low, to avoid additional surgery in the male. From a basic science standpoint, this observation may renew interest in the study of sperm cryopreservation after occurrence of acrosome reaction and hyperactivation.