Fertilization and pregnancy using cryopreserved testicular sperm for intracytoplasmic sperm injection with azoospermia

ObjectivesTo report fertility for men with obstructive (OA) and nonobstructive (NOA) azoospermia after frozen and thawed spermatozoa recovered from the seminiferous tubules and intracytoplasmic sperm injection (ICSI) and to evaluate the factors other than spermatozoa.DesignRetrospective clinical analysis.SettingMale infertility clinic for testicular sperm extraction and freezing/thawing (cryoTESE) and assisted reproductive technologies clinic for ICSI.Patient(s)Seventy-four men with OA and 140 men with NOA undergoing attempted cryoTESE-ICSI.Intervention(s)Seventy-three couples with OA underwent a total of 184 cryoTESE-ICSI cycles, and 46 couples with NOA underwent a total of 75 cryoTESE-ICSI cycles.Main Outcome Measure(s)The numbers of eggs at metaphase II injected, two-pronuclei oocytes, normal cleaved embryos, embryos transfered, transfer cycles, biochemical pregnancies, and clinical pregnancies, as well as the implantation and delivery rates, were examined.Result(s)Fertilization rate in NOA was significantly lower than in OA. Neither the pathology, the source, nor the quantity of spermatozoa had any effect on fertilization or pregnancy rates. Maternal age had no effect on fertilization or embryo cleavage, but did dramatically affect the implantation, pregnancy, and delivery rates in NOA and OA.Conclusion(s)Good pregnancy rates were achieved without significant differences among the sperm sources. The pregnancy and the delivery rate were dependent strictly on the age of the female partner but not on her ovarian reserve.