Analysis of the outcome of intracytoplasmic sperm injection using fresh or frozen sperm

作者：Kalsi Jas^*; Thum M Yau; Muneer Asif; Pryor John; Abdullah Hossam; Minhas Suks

来源：BJU International, 2011, 107(7): 1124-1128.

DOI：10.1111/j.1464-410X.2010.09545.x

• ICSI
• Fresh
• Frozen
• Sperm
• Aetiology

What's known on the subject? and What does the study add?
The results of ICSI using fresh or frozen sperm on the site of sperm retrieval remains controversial with respect to outcome.
The results of this study showed no difference in outcome using ICSI either with respect to the site of retrieval or whether the sperm used was fresh or frozen. It also showed that the outcome of ICSI is not related to the underlying cause of the azoospermia.
OBJECTIVES
center dot To compare the outcome of first-attempt intracytoplasmic sperm injection (ICSI) ICSI-embryo transfer (ET) cycles using frozen-thawed testicular sperm (FTTS), fresh testicular sperm (FTS), frozen-thawed epididymal sperm (FTES) and fresh epididymal sperm (FES) so as to determine which of these has the most successful ICSI outcome with respect to fertilization rate (FR), pregnancy rate (PR) and birth rate.
center dot To assess the outcomes according to the underlying aetiology of azoospermia.
PATIENTS AND METHODS
center dot The records of 493 patients undergoing first-attempt ICSI between 1993 and 2008 were reviewed retrospectively. FTS was used in 112 cycles, FTTS in 43 cycles, FES in 279 cycles, and FTES in 59 cycles.
center dot Within each group, the aetiology of the azoospermia was recorded according to history, clinical examination and histological analysis (n = 316).
center dot The FR, clinical PR and delivery rate were calculated for each group with respect to the type of sperm retrieval used.
RESULTS
center dot Analysis of the data showed no significant differences between any of the four groups in the FR, PR or delivery rate (P > 0.05).
center dot There were no significant differences seen between fresh sperm (FTS and FES) and frozen sperm (FTTS and FTES) or between epididymal sperm (FES and FTES) and testicular sperm (FTS and FTTS) in any of the outcomes measured (P > 0.05). However, sub-set analysis showed a statistically higher FR and PR for FTTS over fresh sperm.
center dot When comparing aetiologies, there was no significant difference in the FR, clinical PR and delivery rate between obstructive azoospermia (OA) and non-obstructive azoospermia (NOA) groups. However, sub-set analysis showed a higher PR and birth rate for FTTS over fresh sperm in both OA and NOA groups.
CONCLUSIONS
center dot The results of the present study suggest that using frozen sperm in ICSI cycles is a reliable and favourable method with the same outcome as fresh sperm.
center dot Testicular and epididymal sperm have similar ICSI outcomes for both fresh and frozen samples. However, results suggest a tendency for higher PRs and birth rates for frozen than for fresh testicular sperm in both OA and NOA aetiologies.
center dot The aetiology of azoospermia does not significantly affect the outcome of first-attempt ICSI. The higher rates in the frozen groups suggest that these patients have had better quality semen when they were initially harvested and frozen.

• 出版日期2011-4