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Comparision the outcome of intracytoplasmic sperm injection cycles with fresh and freezed testicular sperm in azoospermia patients

Comparision the outcome of intracytoplasmic sperm injection cycles with fresh and freezed testicular sperm in azoospermia patients

 

Background: ICSI has resulted in high fertilization and pregnancy rate, with patient having obstructive and nonobstructive azoospermia in particular undergoing testicular sperm extraction. Patient with nonobstructive azoospermia often have small testes and elevated FSH level. Multiple biopsies are difficult to perform in patients with nonobstructive azoospermia, because these patients typically have small testes and dysfunctional spermatogenesis. Therefore it would be beneficial if the frozen_thawed sperm of such patients could be used for repeated cycles of ICSI therapy.

Objective: This study was performed to evaluate fertilization and pregnancy rates in nonobstructive azoospermia patients with the use of fresh or freezed testicular sperm extraction.

Material and method: Between 12 April 2015 and 31 December 2018, 131 ICSI cycles with fresh testicular spermatozoa and 140 cycles with frozen-thawed testicular spermatozoa were carried out.

 Results: The fertilization rate after ICSI with frozen-thawed testicular spermatozoa was lower (67%) than with fresh testicular spermatozoa (74%) (P=0.2). Embryo quality was similar for both groups. The pregnancy rate and rate of ongoing pregnancy was higher in the group which fresh testicular spermatozoa were used (45.2% vs 40%, P=0.6 and 29% vs 25% P=0.7).

Conclusion: This retrospective study shows that although pregnancy rates with the use of fresh sperm extraction seems better than frozen biopsy but this difference is not statistically significant. Therefore frozen-thawed testicular spermatozoa can be used in these patients.

 Keywords: testicular biopsy, ICSI, nonobstructive azoospermia, fertilization rate, pregnancy rate, ongoing pregnancy