Frozen Embryos Generated from Surgically Retrieved Sperm from Azoospermic Men: Are They Clinically Viable?

Abstract

Purpose : To assess the viability of frozen-thawed embryos derived from intracytoplasmic sperm injection (ICSI) in azoospermic men. Methods : Retrospective analysis of 154 consecutive ICSI cycles using surgically retrieved sperm from azoospermic men and case-control comparison of subsequent frozen transfer cycles with those using embryos generated from ejaculated sperm. Results : Patient and fresh cycle characteristics were similar in both groups. There were no differences between the two groups in the proportion of pronucleate (54% and 62%), and cleavage-stage embryos thawed (46% and 38%), post-thaw survival rates (retrievals: 69%; ejaculated: 73%) or quality of frozen embryos subsequently transferred. Implantation was significantly lower in frozen cycles where embryos were generated from surgically retrieved sperm (0% versus 11.5%; p = 0.03). Both clinical pregnancy rate (5% versus 21%) and livebirth rate (0% versus 21%) were lower in this group, but only the difference in LBR reached borderline statistical difference ( p = 0.10). Conclusion : This small series demonstrates a significant impairment in implantation in FET cycles using embryos generated from surgically retrieved sperm and a trend towards a poorer pregnancy outcome.

Effect of Sperm DNA Fragmentation on Clinical Outcome of Frozen-Thawed Embryo Transfer and on Blastocyst Formation

“…However, very little is currently known regarding the impact of sperm DNA fragmentation on clinical outcome of FET. Embryo cryopreservation is a well-established technique that allows the storage of supernumerary embryos created during ART for later transfer [28] . The outcome of FET cycles is affected by several factors including maternal age, number of embryos transferred, and possible differences in frozen-thawed protocols and culture conditions [29] , [30] .…”

Efficacy of cryopreservation of embryos generated by intracytoplasmic sperm injection with spermatozoa from frozen testicular tissue

“…The cryopreservation of zygotes allows for repeated attempts at pregnancy without repeat ovarian stimulation [15]. Nicopoullos et al [14] reported significantly lower implantation rates in FET cycles using embryos generated from surgically retrieved spermatozoa as opposed to those generated from ejaculated spermatozoa (0 % vs. 11.5 %). Both the clinical pregnancy rate (CPR) (5 % vs. 21 %) and the live birth rate (LBR) (0 % vs. 21 %) were lower for embryos generated with surgically retrieved spermatozoa than for those generated with ejaculated spermatozoa.…”

“…Embryo cryopreservation and frozen embryo transfer (FET) is now a well-established technique that allows the storage of supernumerary embryos created by ART [14]. It has several advantages which lower risks such as multiple pregnancies and ovarian hyperstimulation syndrome (OHSS) while providing benefits, e.g.…”

“…While considerable attention has been paid to the efficacy of cryopreservation of embryos generated by ICSI with spermatozoa from frozen testicular tissue, few studies have addressed this topic. Al-Hasani et al [21] reported successful pregnancies using the transfer of frozen pronuclear-stage oocytes obtained by ICSI with spermatozoa extracted from frozen testicular tissues in patients with NOA, and embryos generated following ICSI using surgically retrieved spermatozoa from azoospermic men have also been reported [14].…”

A comparison of post-thaw results between embryos arising from intracytoplasmic sperm injection using surgically retrieved or ejaculated spermatozoa

“…To our knowledge, the only study that reported the outcome of freeze-thaw cycles from embryos generated after ICSI using surgically retrieved sperm from azoospermic men was performed by Nicopoullos et al (20), who used a limited number of freeze-thaw cycles (19 cycles) performed in 10 couples. In this experiment the investigators observed only one ectopic pregnancy, demonstrating that clinical pregnancy (5% and 21%, respectively), implantation (0 and 11.5%, respectively), and live birth rates (0 and 21%) were lower in the surgically retrieved group when compared with the ejaculated group.…”