Human Reproduction, Vol 13, 1872-1877, Copyright © 1998 by Oxford University Press
S Friedler, A Raziel, Y Soffer, D Strassburger, D Komarovsky and R Ron-El
The aim of our study was to compare the outcome of intracytoplasmic sperm
injection (ICSI) with fresh and frozen-thawed epididymal spermatozoa
retrieved by percutaneous epididymal sperm aspiration (PESA) or
microepididymal sperm aspiration (MESA) from patients with obstructive
azoospermia. A retrospective analysis of consecutive ICSI cycles was
performed, comparing the outcome in 24 patients with obstructive
azoospermia undergoing surgical sperm aspiration by MESA (7 cycles) or PESA
(17 cycles). In 23 of 24 patients, excess spermatozoa were cryopreserved.
Following thawing, 21 ICSI cycles were performed (11 cycles after MESA, 10
after PESA). No statistically significant differences were noted in all
parameters examined in ICSI cycles with fresh or cryopreserved spermatozoa
from the same patients. Comparing all ICSI cycles with fresh and
frozen-thawed epididymal spermatozoa, the rates of two-pronuclear
fertilization (56% versus 53%), embryo cleavage (90% versus 86%),
implantation (10% versus 14%), clinical pregnancy per embryo transfer (32%
versus 37%) and delivery/ongoing pregnancy rate (27% versus 26%) were not
statistically different. The cumulative ongoing pregnancy rate per sperm
retrieval procedure was 46%, respectively. We conclude that the clinical
outcome of ICSI with fresh and frozen-thawed spermatozoa after retrieval by
PESA was similar to that by MESA. Epididymal sperm cryopreservation in
patients with obstructive azoospermia is feasible and efficient using a
simple freezing protocol and should be offered to optimize the yield of
pregnancies achieved following such procedures.
ARTICLES
The outcome of intracytoplasmic injection of fresh and cryopreserved epididymal spermatozoa from patients with obstructive azoospermia--a comparative study
Department of Obstetrics and Gynecology, Assaf Harofeh Medical Center, Zerifin, Israel.
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