Human Reproduction, Vol 12, 734-739, Copyright © 1997 by Oxford University Press
RD Oates, J Mulhall, C Burgess, D Cunningham and R Carson
Testicular tissue extraction (TESE) to obtain spermatozoa for use with
intracytoplasmic sperm injection (ICSI) has recently been employed in
patients with non-obstructive azoospermia. Standard protocol is to retrieve
a new sample of testis tissue on the day of oocyte recovery. Unfortunately,
approximately 30% of men will possess no spermatozoa in their tissue,
making ICSI an impossibility. We investigated whether testicular tissue
that was intentionally obtained well before any planned ICSI cycle and
cryopreserved could then serve as an efficacious sperm source in a
subsequent ICSI cycle. This study reports on 10 men with non-obstructive
azoospermia who did have spermatozoa found within their testis tissue at
the time of TESE and who chose to use their frozen samples as the source of
spermatozoa for a later cycle of ICSI. In 19 cycles the overall
fertilization rate was 48%. Embryo transfer occurred in 89% of cycles. Two
couples have achieved pregnancy (one ongoing, one delivered). All patients
except one had multiple vials of frozen tissue remaining following their
first cycle. This approach is offered as an alternative to repeated
testicular tissue sampling, as the availability of spermatozoa is assured
prior to the initiation of ovulation induction. This tissue can be
harvested at the same time as diagnostic biopsy, thereby minimizing the
number of surgical procedures.
ARTICLES
Fertilization and pregnancy using intentionally cryopreserved testicular tissue as the sperm source for intracytoplasmic sperm injection in 10 men with non-obstructive azoospermia
Department of Urology, Boston University School of Medicine, MA 02118, USA.
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