Fertilization after intracytoplasmic sperm injection with cryopreserved testicular spermatozoa.

OBJECTIVE

To assess the possibility of cryopreserving testicular tissue extracted sperm for intracytoplasmic sperm injection (ICSI).

DESIGN

A report of two cases. Our study was approved by the Ethical Committee at the Instituto Valenciano de Infertilidad.

SETTING

In vitro fertilization program at the Instituto Valenciano de Infertilidad.

PATIENTS

Two azoospermic patients with severe spermatogenic failure but with focal spermatogenesis on testicular biopsies. In both cases, a first ICSI attempt with fresh testicular biopsy extracted sperm was unsuccessful.

INTERVENTIONS

Cryopreservation of testicular spermatozoa in 100-micro L "pills." Intracytoplasmic sperm injection with thawed testicular spermatozoa.

MAIN OUTCOME MEASUREMENTS

Fertilization rate, cleavage rate, embryo quality, clinical pregnancy.

RESULTS

Fertilization rates were 36 percent and 100 percent after ICSI with fresh testicular spermatozoa, and 63 percent and 57 percent after ICSI with cryopreserved testicular sperm. In both cases, cleavage rates and embryo quality were similar when using fresh and cryopreserved testicular spermatozoa. No clinical pregnancies were achieved.

CONCLUSION

High fertilization rates can be obtained after ICSI with frozen-thawed testicular tissue extracted spermatozoa. Cryopreservation of testicular sperm may avoid repetition of testicular biopsies in azoospermic patients in whom the only source of spermatozoa is the testicle.