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Hum. Reprod. Advance Access originally published online on August 1, 2007
Human Reproduction 2007 22(10):2679-2684; doi:10.1093/humrep/dem190
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Optimal management of extreme oligozoospermia by an appropriate cryopreservation programme

I. Koscinski1,2,3,5, C. Wittemer2, V. Lefebvre-Khalil3, F. Marcelli4, A. Defossez3 and J.M. Rigot4

1 Laboratoire de Biologie de la Reproduction, Centre Hospitalier Universitaire de Strasbourg, CMCO-SIHCUS, 19 rue Louis Pasteur, BP120, 67303 Schiltigheim Cedex, France 2 Université Louis Pasteur de Strasbourg, Faculté de Médecine, 4 rue Kirschleger, 67085 Strasbourg Cedex, France 3 Laboratoire de Biologie de la Reproduction, Hôpital Jeanne de Flandre, CHRU Lille, 2 rue Oscar Lambret, 59037 Lille Cedex, France 4 Service d'Andrologie, Hôpital Calmette, CHRU Lille, 59037 Lille Cedex, France

5 Correspondence address. Tel: +33 388 62 84 46; Fax: +33 388 62 84 45; E-mail: isabelle.koscinski{at}chru-strasbourg.fr

BACKGROUND: Severe oligozoospermia is characterized by sperm count fluctuations that may result in insufficient quantities of motile sperm for ICSI on the day of oocyte retrieval, thus necessitating testicular biopsy. To avoid this, we proposed that patients, with transient azoospermia or repeatedly low sperm counts, make a safety pool of frozen spermatozoa before ICSI attempts.

METHODS: Seventy cryptozoospermic (<103 spermatozoa/ml) and 46 oligozoospermic patients (103–105/ml) were included. Although all oligozoospermic patients succeeded in sperm banking, only 44 of 70 cryptozoospermic patients were successful. Others underwent testicular extraction of spermatozoa. The ICSI results for frozen sperm from cryptozoospermic patients were compared with those obtained with fresh sperm from a group of normal patients (>105 spermatozoa/ml).

RESULTS: In this prospective matched, controlled study, five cryptozoospermic, but no oligozoospermic, patients failed to produce sperm on the ICSI day, and frozen sperm was used instead. Although fertilization and pregnancy rates (per attempt) using fresh (49% and 5/44, respectively) and frozen sperm (54% and one-fifth, respectively) were similar for this cryptozoospermic group, the results for fresh sperm were significantly lower when compared with the control group (66% and 16/43, P < 0.0001, P < 0.001, respectively). In contrast, results for the oligospermic and control groups were similar.

CONCULSIONS: Banking of ejaculated sperm is helpful for cryptozoospermic patients.

Key words: cryopreservation/cryptozoospermia/ICSI/oligozoospermia

Submitted on January 8, 2006; resubmitted on April 18, 2007; accepted on April 28, 2007.


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