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Human Reproduction, Vol. 14, No. 4, 1034-1038, April 1999
© 1999 European Society of Human Reproduction and Embryology

Diagnostic testicular biopsy and cryopreservation of testicular tissue as an alternative to repeated surgical openings in the treatment of azoospermic men

L. Gianaroli1,4, M.C. Magli1, H.A. Selman1, G. Colpi2, E. Belgrano3, C. Trombetta3, G. Vitali1 and A.P. Ferraretti1

1 S.I.S.ME.R., Reproductive Medicine Unit, V. Mazzini 12, 40138 Bologna, 2 Andrology Service, Ob-Gyn Clinic, University of Milan, San Paolo Hospital, 20100 Milan and 3 Clinic of Urology, Cattinara Hospital, 34100 Trieste, Italy

Between May 1996 and May 1998, 64 azoospermic patients underwent an investigative testicular biopsy combined with the cryopreservation of spermatozoa which were retrieved from a simultaneously examined fresh sample. Testicular tissue cryopreservation was carried out in 43 cases (67%) for late intracytoplasmic sperm injection (ICSI) attempts. In all, 23 couples underwent 26 assisted conception cycles; the fertilization rate was 64% with spermatozoa (139/218, 24 cycles), 40% with round spermatids (2/5, one cycle), and 69% with elongated spermatids (9/13, one cycle). The embryo cleavage rate was 84%. A mean number of 2.7 ± 0.7 embryos were replaced in 24 patients. In two cases, embryo quality was very poor and they were not transferred. Eight clinical pregnancies resulted (35% per patient and 33% per transferred cycle) with an implantation rate of 14.1%: two patients have already delivered and six are ongoing. In conclusion, the cryopreservation of testicular tissue during the first diagnostic biopsy is an alternative to repeated surgical openings and permits patients to initiate an ovarian stimulation cycle with the certitude of having spermatozoa available. Moreover, since only one straw is routinely used for each ICSI cycle, the frozen tissue remains as a sperm source for multiple attempts.

Key words: azoospermia/cryopreservation/intracytoplasmic sperm injection/testicular sperm extraction

4 To whom correspondence should be addressed


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