[Pregnancies after in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) of testicular spermatozoa (TESE) from frozen semen].

This case report describes the possibility of establishing intact pregnancies by using cryopreserved testicular sperm for in-vitro-fertilization (IVF) with intracytoplasmatic sperm injection (ICSI). Because of a bilateral postinflammatory occlusion of the ductus deferens the patient underwent two cycles of IVF without ICSI by using epididymal sperm (MESA), however no fertilization occurred. In a third attempt with ICSI we used testicular sperm (TESE), because epididymal sperm was not detectable any longer. No pregnancy was established. In the forth treatment cycle again IVF/ICSI, now using cryopreserved and thawed testicular sperm. After embryotransfer (ET) of two preimplantation embryos into the uterine cavity, an intact singleton pregnancy was established. Meanwhile 15 further patients concept after IVF/ICSI using frozen and thawed testicular sperm. The German Embryo Protection Act (ESchG) prohibits the intentional fertilisation of more than three oocytes during one treatment cycle or the cryopreservation of human preimplantation embryos. Therefore it is mandatory to extract testicular sperm for every treatment cycle. Cryopreservation of testicular sperm is offering a legal possibility to avoid repeated testicular biopsies and has acceptable success rates for concerning couples.