The outcome of ICSI Cycles with Fresh Testicular Spermatozoa Obtained on the Day of or the Day before Oocyte Collection and with Cryopreserved Testicular Sperm in Patients with Azoospermia
DOI:
https://doi.org/10.63682/jns.v13i1.8669Keywords:
ICSI, azoospermia, fresh testicular sperm, cryopreserved sperm, fertilization rate, embryo quality, clinical pregnancy rate, live birth rateAbstract
Background: Infertility affects a significant proportion of couples worldwide, and male factor infertility accounts for approximately 40-50% of all cases.
Objective: To evaluate the outcomes of Intracytoplasmic Sperm Injection (ICSI) cycles using fresh testicular spermatozoa obtained on the day of or the day before oocyte collection, compared to cycles utilizing cryopreserved testicular sperm, in patients with azoospermia.
Methodology: This retrospective cohort study was conducted at Institute of Kidney Diseases, Hayatabad Medical Complex, Peshawar during December 2021 to May 2023. Data from 100 ICSI cycles were analyzed, with 50 cycles utilizing fresh testicular sperm and 50 cycles utilizing cryopreserved testicular sperm.
Results: A total of 100 ICSI cycles were analysed, with no significant differences observed in male age (34.2 ± 5.1 years vs. 34.5 ± 5.2 years, p = 0.85), female age (31.4 ± 4.8 years vs. 31.1 ± 4.6 years, p = 0.79), type of azoospermia, or sperm retrieval method. In both groups, 56% (28/50) of patients had obstructive azoospermia, while 44% (22/50) had non-obstructive azoospermia in the fresh sperm group and 58% (29/50) and 42% (21/50) in the cryopreserved sperm group (p = 0.88). Sperm retrieval methods (TESE: 44% vs. 42%, micro-TESE: 56% vs. 58%) were also comparable (p = 0.79). Previous ART cycles were similar (1.3 ± 0.6 vs. 1.4 ± 0.7, p = 0.62), and the number of oocytes retrieved was identical (30 ± 5 in both groups, p = 0.96). Female BMI was also comparable (24.5 ± 3.3 kg/m² vs. 24.8 ± 3.4 kg/m², p = 0.76).
Conclusion: It is concluded that fresh testicular sperm significantly improves the outcomes of ICSI cycles in men with azoospermia compared to cryopreserved testicular sperm. The study demonstrated higher fertilization rates, better embryo quality, and increased clinical pregnancy and live birth rates in the fresh sperm group.
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Niederberger C. Re: outcome of intracytoplasmic sperm injection cycles with fresh testicular spermatozoa obtained on the day of or the day before oocyte collection and with cryopreserved testicular sperm in patients with azoospermia. J Urol. 2014 Jul;192(1):180. doi: 10.1016/j.juro.2014.04.059. PMID: 25629112.
Lin PY, Huang CC, Chen HH, Huang BX, Lee MS. Failed sperm retrieval from severely oligospermic or non-obstructive azoospermic patients on oocyte retrieval day: Emergent oocyte cryopreservation is a feasible strategy. PLoS One. 2019 Nov 18;14(11):e0224919. doi: 10.1371/journal.pone.0224919. PMID: 31738801; PMCID: PMC6860430.
Suleymanova L, Bayram H, Dönmez Çakıl Y, Selam B, Cincik M. Pregnancy outcomes in patients with non-obstructive azoospermia undergoing micro-TESE: comparison of fresh vs. frozen-thawed testicular sperm. J Assist Reprod Genet. 2024 Dec;41(12):3399-3404. doi: 10.1007/s10815-024-03291-7. Epub 2024 Oct 21. PMID: 39432191; PMCID: PMC11707213
Cerván-Martín M, Castilla JA, Palomino-Morales RJ, Carmona FD. Genetic landscape of nonobstructive azoospermia and new perspectives for the clinic. J Clin Med. 2020;9(2):300.
Liu H, Xie Y, Gao L, Sun X, Liang X, Deng C, et al. Impact on using cryopreservation of testicular or epididymal sperm upon intracytoplasmic sperm injection outcome in men with obstructive azoospermia: a systematic review and meta-analysis. J Assist Reprod Genet. 2020;37(11):2643–51.
Yu Z, Wei Z, Yang J, Wang T, Jiang H, Li H, et al. Comparison of intracytoplasmic sperm injection outcome with fresh versus frozen-thawed testicular sperm in men with nonobstructive azoospermia: a systematic review and meta-analysis. J Assist Reprod Genet. 2018;35(7):1247–57.
Alkandari MH, Zini A. Medical management of non-obstructive azoospermia: a systematic review. Arab J Urol. 2021;19(3):215–20.
Pelit E, Çiftçi H. The first report from Harran University Department of Urology on microscopic testicular sperm extraction results in non-obstructive azoospermic patients. J Harran University Med Faculty. 2019;16(1):134–8
Uçar M, Oksay T, Özorak A, Soyupek S, Armağan A, Koşar A. Nonobstruktif Azospermik Hastalarda Yapılan Mikrocerrahi Testiküler Sperm Ekstraksiyonu Sonuçları ve Bu Sonuçları Etkileyen Faktörlerin Değerlendirilmesi. Acta Medica Alanya. 2017;1(3):122–6.
Schulz M, Risopatrón J, Uribe P, Isachenko E, Isachenko V, Sánchez R. Human sperm vitrification: a scientific report. Andrology. 2020;8(6):1642–50.
Schachter-safrai N, Karavani G, Levitas E, Friger M, Zeadna A, Lunenfeld E, et al. Does cryopreservation of sperm affect fertilization in nonobstructive azoospermia or cryptozoospermia? Fertil Steril. 2017;107(5):1148–52
Neifar S, Chtourou S, Braham M, Chakroun M, Debbabi L, Frikha W, et al. P-072 Fresh testicular sperm seems to yield more fertilization abnormalities and early pregnancy loss than frozen testicular sperm. Hum Reprod. 2024;39(Supplement_1):deae108.448.
Coward RM, Mills JN. A step-by-step guide to office-based sperm retrieval for obstructive azoospermia. Transl Androl Urol. 2017;6(4):730–44.
Sacha CR, Vagios S, Hammer K, Fitz V, Souter I, Bormann CL. The effect of semen collection location and time to processing on sperm parameters and early IVF/ICSI outcomes. J Assist Reprod Genet. 2021;38(6):1449–57.
Agca Y, Critser JK. Cryopreservation of spermatozoa in assisted reproduction. Semin Reprod Med. 2002;20(1):015–24
Zhang Y, Zhang H, Zhao J, Zhao Y, Zhang J, Jiang L, et al. Gravidity modifies the associations of age and spousal age difference with couple’s fecundability: a large cohort study from China. Hum Reprod. 2023;39(1):dead209
Wang Y, Liu D, Ren X, Lin S, Li M, Jiang H, et al. Fresh gametes might get better clinical results than cryopreserved sperm or oocytes for nonobstructive azoospermia patients underwent micro-TESE. Clin Exp Obstet Gynecol. 2022;49(6):128.
Madureira C, Cunha M, Sousa M, Neto AP, Pinho MJ, Viana P, et al. Treatment by testicular sperm extraction and intracytoplasmic sperm injection of 65 azoospermic patients with non-mosaic Klinefelter syndrome with birth of 17 healthy children. Andrology. 2014;2(4):623–31
Zhang HL, Mao JM, Liu DF, Zhao LM, Tang WH, Hong K, et al. Clinical outcomes of microdissection testicular sperm extraction-intracytoplasmic sperm injection with fresh or cryopreserved sperm in patients with nonobstructive azoospermia. Asian J Androl. 2021;23(2):211.
Ngwenya O, Lensen SF, Vail A, Mol BWJ, Broekmans FJ, Wilkinson J. Individualised gonadotropin dose selection using markers of ovarian reserve for women undergoing in vitro fertilisation plus intracytoplasmic sperm injection (IVF/ICSI). Cochrane Database Syst Rev. 2024 Jan 4;1(1):CD012693. doi: 10.1002/14651858.CD012693.pub3. PMID: 38174816; PMCID: PMC10765476.
Glujovsky D, Pesce R, Miguens M, Sueldo C, Ciapponi A. Progestogens for prevention of luteinising hormone (LH) surge in women undergoing controlled ovarian hyperstimulation as part of an assisted reproductive technology (ART) cycle. Cochrane Database Syst Rev. 2023 Nov 30;11(11):CD013827. doi: 10.1002/14651858.CD013827.pub2. PMID: 38032057; PMCID: PMC10687848.
Cambiaghi AS, de Barros Ferreira Leario R, Alvarez A V, Martins Araujo PB, Nascimento PF. Dydrogesterone for prevent LH surge yields similar outcomes to ganirelix in a shared oocyte donor cycle with subsequent frozen-thawed embryo transfer: comparison of donors and recipients. Fertility and Sterility. Conference: 75th Scientific Congress of the American Society for Reproductive Medicine, October 12-16, 2019, Philadelphia, Pennsylania 2019;112 Suppl:e195
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