Efficiency of using frozen-thawed testicular sperm for multiple intracytoplasmic sperm injections

Purpose. To compare fertilization and pregnancy rates of fresh and frozen-thawed testicular sperm injections (TESE-ICSI). Methods: Sperm collected,from the testes of 28 azoospermic patients by an open testicular biopsy technique was used for initial ICSI or cryopreserved. Results. Fresh-sperm ICSI treatment (28 cycles) resulted in a 58.1 % fertilization rate and a 32.1 % clinical pregnancy rate per embryo transfer; while frozen-thawed sperm (24 sub-segment cycles) had rates of 54.5 and 29.2%, respectively. The PR was lower using frozen-thawed sperm from nonobstructive azoospermia patients (9.1 %) than from obstructive azoospermia patients (46.2 %). PR declined to 0% upon the fourth ICSI attempt. Conclusions: Fertilization, embryo cleavage, and pregnancy rates were unaffected by fresh or frozen-thawed sperm use. A 57.1 % cumulative clinical PR was achieved using the latter. The PR was significantly lower using frozen-thawed sperm from nonobstructive azoospermia patients than from obstructive azoospermia patients.