Optimal use of fresh and frozen-thawed testicular sperm for intracytoplasmic sperm injection in azoospermic patients

  • Bin Wu
  • Diana Wong
  • Suzhen Lu
  • Stephen Dickstein
  • Marta Silva
  • Timothy J. Gelety


Purpose: To optimize the use of fresh and frozen-thawed testicular biopsy specimens from patients with azoospermia.

Methods: Fifty-one patients suffering from obstructive and non-obstructive azoospermia underwent testicular sperm extraction (TESE). The specimens were divided and used for either in vitro maturation or freezing for a future intracytoplasmic sperm injection (ICSI) cycle.

Results: At initial testicular sperm extraction, very few motile spermatozoa were seen. After 24 h of in vitro maturation, sperm motility increased remarkably, with a maximum motility rate seen between 48 and 72 h of culture. Motile spermatozoa were observed up to 120 h in culture. In the 22 fresh ICSI cycles, a total of 294 oocytes were injected using motile sperm and 212 oocytes demonstrated normal 2PN formation (fertilization rate, 72.1%). In 36 frozen-thawed ICSI cycles, a total of 454 oocytes were injected and 302 oocytes became 2PN (66.5%). On day 3, high quality embryos were observed in 54.2% of fresh cycles and 54.1% of frozen cycles (P > 0.05). The clinical pregnancy rate did not show a significant difference between using fresh (59%) and frozen (55.5%) testicular biopsy sperm for ICSI (P > 0.05), but the embryo implantation rates did differ significantly between fresh (29.5%) and frozen-thawed (22.2%) cycles (P < 0.05). A total of 33 healthy babies have been born from 22 women, giving birth after 58 embryo transfer attempts (38%).

Conclusion: The freezing and in vitro culturing of testicular biopsy tissue is a very reliable approach for the management of testicular biopsy specimens from azoospermic patients, and offers the possibility of several treatments of IVF/ICSI from a single sample.


Cryopreservation in vitro maturation testicular sperm extraction 


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Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  • Bin Wu
    • 1
    • 2
  • Diana Wong
    • 1
  • Suzhen Lu
    • 1
  • Stephen Dickstein
    • 1
  • Marta Silva
    • 1
  • Timothy J. Gelety
    • 1
  1. 1.Arizona Center for Reproductive Endocrinology and InfertilityTucson
  2. 2.College of Animal Science and Veterinary MedicineNorthwest A&F UniversityYanglingP.R. China

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