Efficacy of intracytoplasmic sperm injection using intentionally cryopreserved epididymal spermatozoa

Abstract

Microsurgical epididymal sperm aspiration was a great advance in the therapy of patients with non-reconstructable, obstructive azoospermia, most notably congenital bilateral absence of the vas deferens. Using conventional in-vitro fertilization, pregnancies were rarely achieved because the rate of oocyte fertilization was extremely poor. However, the use of retrieved spermatozoa in conjunction with intracytoplasmic sperm injection (ICSI) has dramatically increased the likelihood of embryo formation. Typically, sperm and oocyte harvesting are performed simultaneously. We have investigated whether frozen-thawed spermatozoa work as well as fresh spermatozoa. When we had concluded from our own population of patients (groups I and II) that they did, we adopted a policy of aspirating spermatozoa, primarily cryopreserving them and using them for ICSI at a later date. We found the fertilization rates of this latter cohort of patients (group III) to be excellent (37% per oocyte), and the ongoing pregnancy rate is quite satisfactory (40% per couple, 29% per cycle). We offer this approach as an alternative to the traditional scheme because it markedly eases the burden of partner scheduling on both the couple and the clinicians involved. In addition, assurance of the availability of male partner spermatozoa can be attained prior to beginning ovulation induction.

Effects of freeze-drying on cytology, ultrastructure, DNA fragmentation, and fertilizing ability of bovine sperm

“…We demonstrated for the first time that EGTA solution, which is widely used in mice [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13] and [14], efficiently preserved the nucleus, acrosome and mitochondria of bovine sperm. In addition, we showed that presence of trehalose in medium supplement with FCS provided better protection to bovine sperm than the medium with FCS alone.…”

“…Therefore, despite substantially reduced motility, cells remained viable, based on the fact that sperm nucleus and centrosome integrity are essential for the success of ICSI [11].…”

In Vitro Retrieval of Epididymal Sperm: An Analysis of 11 Years of Cumulative Data

“…It has also been reported by investigators using MESA that the majority of epididymal sperm can be retrieved from the head area of the epididymis. 12 Nevertheless, we found that, a substantial numbers of sperms are also present in the body and tail of the epididymis in many cases (Fig. 4).…”

Pregnancy Outcome of Intracytoplasmic Sperm Injection in Relation to Duration of Cryopreservation of Spermatozoa Obtained through Testicular Sperm Extraction

“…Indeed, some proponents suggest that this is the optimum form of treatment [22] and should be used exclusively.…”