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Hum. Reprod. Advance Access published online on October 18, 2004
Human Reproduction, doi:10.1093/humrep/deh490
© 2004 by European Society of Human Reproduction and Embryology
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Received March 5, 2004
Revised June 24, 2004
Accepted August 2, 2004

Article

Should diagnostic testicular sperm retrieval followed by cryopreservation for later ICSI be the procedure of choice for all patients with non-obstructive azoospermia?

G. Verheyen 1*, V. Vernaeve 1, L. Van Landuyt 1, H. Tournaye 1, P. Devroey 1, and A. Van Steirteghem 1

1 Centre for Reproductive Medicine, University Hospital of the Dutch-speaking Brussels Free University, Laarbeeklaan 101, B-1090 Brussels, Belgium

* To whom correspondence should be addressed.
G. Verheyen, E-mail: greta.verheyen{at}az.vub.ac.be


  Abstract

BACKGROUND: This was a retrospective study to determine if diagnostic testicular biopsy followed by cryopreservation should be the procedure of choice for all patients with testicular failure. METHODS: The first part of the study analysed 97 ICSI cycles scheduled with frozen-thawed testicular sperm for 69 non-obstructive azoospermia (NOA) patients. The second part focused on a subgroup of 32 patients who underwent 42 ICSI cycles with frozen and 44 cycles with fresh testicular sperm. Sperm characteristics, fertilization, embryo quality, pregnancy and implantation rates were evaluated. RESULTS: Part I: The average time needed to find sperm was 113 min per cycle and 17 min per individual sperm. Fertilization rate, embryo transfer rate, ongoing pregnancy and implantation rates were 58.4%, 83%, 20.8% and 11.3%, respectively. Part II: The search time per sperm was higher (P=0.016) in frozen (18 min) than in fresh suspensions (13 min). A higher embryo transfer rate was observed in fresh cycles than in frozen cycles (93.2% vs 76.2%, P=0.028). Fertilization, ongoing pregnancy and implantation rates were comparable for the two groups. CONCLUSIONS: Even in a programme with low-restrictive criteria for patient allocation and for sperm cryopreservation, diagnostic testicular biopsy followed by cryopreservation can be the procedure of choice for patients with testicular failure.

Keywords: cryopreservation; ICSI; non-obstructive azoospermia; pregnancies; testicular sperm.
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