Fertilization after intracytoplasmic sperm injection with cryopreserved testicular spermatozoa

Objective: To assess the possibility of cryopreserving testicular tissue extracted sperm for intracytoplasmic sperm injection (ICSI). Design: A report of two eases. Our study was approved by the Ethical Committee at the Institute Valenciano de Infertilidad. Setting: In vitro fertilization program at the Institute Valenciano de Infertilidad. Patients: Two azoospermic patients with severe spermatogenic failure but with focal spermatogenesis on testicular biopsies. In both cases, a first ICSI attempt with fresh testicular biopsy extracted sperm was unsuccessful. Interventions: Cryopreservation of testicular spermatozoa in 100-mu L ''pills.'' Intracytoplasmic sperm injection with thawed testicular spermatozoa. Main Outcome Measurements: Fertilization rate, cleavage rate, embryo quality, clinical pregnancy. Results: Fertilization rates were 36% and 100% after ICSI with fresh testicular spermatozoa, and 63% and 57% after ICSI with cryopreserved testicular sperm. In both cases, cleavage rates and embryo quality were similar when using fresh and cryopreserved testicular spermatozoa. No clinical pregnancies were achieved. Conclusion: High fertilization rates can be obtained after ICSI with frozen-thawed testicular tissue extracted spermatozoa. Cryopreservation of testicular sperm may avoid repetition of testicular biopsies in azoospermic patients in whom the only source of spermatozoa is the testicle.