Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Journal of Assisted Reproduction and Genetics
Published in: Journal of Assisted Reproduction and Genetics 7/2018

01-07-2018 | Assisted Reproduction Technologies

Comparison of intracytoplasmic sperm injection outcome with fresh versus frozen-thawed testicular sperm in men with nonobstructive azoospermia: a systematic review and meta-analysis

Authors: Zhe Yu, Zhewen Wei, Jun Yang, Tao Wang, Hongyang Jiang, Hao Li, Zhe Tang, Shaogang Wang, Jihong Liu

Published in: Journal of Assisted Reproduction and Genetics | Issue 7/2018

Login to get access

Abstract

Purpose

The purpose of the study is to explore testicular sperm cryopreservation in patients with nonobstructive azoospermia (NOA) whether affect the outcome of subsequent intracytoplasmic sperm injection (ICSI).

Methods

A systematic review and meta-analysis was conducted by searching the MEDLINE and EMBASE databases for relevant published studies in English language (1997–2017). Studies were eligible if they included the comparison of using fresh and frozen-thawed testicular sperm followed by ICSI. Two reviewers independently performed data extraction, quality assessment and assessed the risk of bias. The overall summary risk estimated the number of events. A meta-analysis was conducted using a random effects or fixed effects model analysis according to the test of heterogeneity.

Results

A total of 17 studies with 1,261 ICSI cycles were identified. Analysis of the present data showed no difference in the fertilization outcome when comparing fresh versus frozen-thawed spermatozoa (RR = 1.02, 95% CI 0.86–1.09). Similarly, no difference in CR (RR = 1.01, 95% CI 0.96–1.05), good embryo rate (RR = 1.01, 95% CI 0.95–1.09), and IR (RR = 0.93, 95% CI 0.66–1.30) was observed if the spermatozoa was fresh or frozen-thawed. Finally, no difference in CPR or LBR was noted when using fresh or frozen-thawed cycles were analyzed separately (RR = 1.03, 95% CI 0.86–1.24; RR 1.11, 95% CI 0.88–1.41, respectively).

Conclusions

In men with NOA, the ICSI outcome is not affected by whether the retrieved testicular sperm is fresh or frozen. Sperm cryopreservation ought to be considered in every surgical sperm retrieval case, which remain feasible even in patients with few testicular sperm retrieved.
Literature
1.
2.
Franco G, Misuraca L, Ciletti M, Leonardo C, De Nunzio C, Palminteri E, et al. Surgery of male infertility: an update. RU. 2014;81:154–64.CrossRef
3.
Ishikawa T. Surgical recovery of sperm in non-obstructive azoospermia. Asian J Androl. 2012;14:109–15.CrossRefPubMed
4.
Haimov-Kochman R, Lossos F, Nefesh I, Zentner B-S, Moz Y, Prus D, et al. The value of repeat testicular sperm retrieval in azoospermic men. Fertil Steril. 2009;91:1401–3.CrossRefPubMed
5.
Gianaroli L. Diagnostic testicular biopsy and cryopreservation of testicular tissue as an alternative to repeated surgical openings in the treatment of azoospermic men. Hum Reprod. 1999;14:1034–8.CrossRefPubMed
6.
Oates RD, Mulhall J, Burgess C, Cunningham D, Carson R. Fertilization and pregnancy using intentionally cryopreserved testicular tissue as the sperm source for intracytoplasmic sperm injection in 10 men with non-obstructive azoospermia. Hum Reprod. 1997;12:734–9.CrossRefPubMed
7.
Park YS, Lee S-H, Lim CK, Cho JW, Yang KM, Seo JT. Effect of testicular spermatozoa on embryo quality and pregnancy in patients with non-obstructive azoospermia. Syss Biol Reprod Med. 2015;61:300–6.CrossRef
8.
Madureira C, Cunha M, Sousa M, Neto AP, Pinho MJ, Viana P, et al. Treatment by testicular sperm extraction and intracytoplasmic sperm injection of 65 azoospermic patients with non-mosaic Klinefelter syndrome with birth of 17 healthy children. Andrology. 2014;2:623–31.CrossRefPubMed
9.
10.
Ohlander S, Hotaling J, Kirshenbaum E, Niederberger C, Eisenberg ML. Impact of fresh versus cryopreserved testicular sperm upon intracytoplasmic sperm injection pregnancy outcomes in men with azoospermia due to spermatogenic dysfunction: a meta-analysis. Fertil Steril. 2014;101:344–9.CrossRefPubMed
11.
Schlegel PN. Testicular sperm extraction: microdissection improves sperm yield with minimal tissue excision. Hum Reprod. 1999;14:131–5.CrossRefPubMed
12.
Flannigan R, Bach PV, Schlegel PN. Microdissection testicular sperm extraction. Trans Androl Urol. 2017;6:745–52.CrossRef
13.
Bernie AM, Shah K, Halpern JA, Scovell J, Ramasamy R, Robinson B, et al. Outcomes of microdissection testicular sperm extraction in men with nonobstructive azoospermia due to maturation arrest. Fertil Steril. 2015;104:569–573.e1.CrossRefPubMed
14.
Gil-Salom M, Romero J, Menguez Y, Rubio C, De los Santos MJ, Remohe J, et al. Pregnancies after intracytoplasmic sperm injection with cryopreserved testicular spermatozoa. Hum Reprod. 1996;11:1309–13.CrossRefPubMed
15.
Friedler S, Raziel A, Soffer Y, Strassburger D, Komarovsky D, Ron-El R. Intracytoplasmic injection of fresh and cryopreserved testicular spermatozoa in patients with nonobstructive azoospermia—a comparative study. Fertil Steril. 1997;68:892–7.CrossRefPubMed
16.
Bin W, Wong D, Lu S, Dickstein S, Silva M, Gelety TJ. Optimal use of fresh and frozen-thawed testicular sperm for intracytoplasmic sperm injection in azoospermic patients. J Assis Reprod Genet. 2005;22:389–94.CrossRef
17.
Agca Y, Critser JK. Cryopreservation of spermatozoa in assisted reproduction. Semin Reprod Med. 2002;20:015–24.CrossRef
18.
Gómez-Torres MJ, Medrano L, Romero A, Fernández-Colom PJ, Aizpurúa J. Effectiveness of human spermatozoa biomarkers as indicators of structural damage during cryopreservation. Cryobiology. 2017;78:90–4.CrossRefPubMed
19.
Verheyen G, Nagy Z, Joris H, Croo ID, Tournaye H, Steirteghem AV. Quality of frozen-thawed testicular sperm and its preclinical use for intracytoplasmic sperm injection into in vitro-matured germinal-vesicle stage oocytes. Fertil Steril. 1997;67:74–80.CrossRefPubMed
20.
Chatterjee S, Gagnon C. Production of reactive oxygen species by spermatozoa undergoing cooling, freezing, and thawing. Mol Reprod Dev. 2001;59:451–8.CrossRefPubMed
21.
Ben-Yosef D, Yogev L, Hauser R, Yavetz H, Azem F, Yovel I, et al. Testicular sperm retrieval and cryopreservation prior to initiating ovarian stimulation as the first line approach in patients with non-obstructive azoospermia. Hum Reprod. 1999;14:1794–801.CrossRefPubMed
22.
Konc J, Kanyó K, Cseh S. The effect of condition/state of testicular spermatozoa injected to the outcome of TESE–ICSI–ET cycles. Eur J Obstet Gynecol Reprod Bio. 2008;141:39–43.CrossRef
23.
de Oliveira NM. Pregnancy with frozen-thawed and fresh testicular biopsy after motile and immotile sperm microinjection, using the mechanical touch technique to assess viability. Hum Reprod. 2004;19:262–5.CrossRefPubMed
24.
Nijs M, Vanderzwalmen P, Vandamme B, Segal-Bertin G, Lejeune B, Segal L, et al. Andrology: fertilizing ability of immotile spermatozoa after intracytoplasmic sperm injection. Hum Reprod. 1996;11:2180–5.CrossRefPubMed
25.
Hauser R. Severe hypospermatogenesis in cases of nonobstructive azoospermia: should we use fresh or frozen testicular spermatozoa? J Androl. 2005;26:772–8.CrossRefPubMed
26.
Miah A, Salma U, Schellander K. Roles of relaxin on in vitro sperm physiology. Reprod Domest Anim. 2015;50:125–5.
27.
Aitken RJ, Mattei A, Irvine S. Paradoxical stimulation of human sperm motility by 2-deoxyadenosine. Reproduction. 1986;78:515–27.CrossRef
28.
Stephens TD, Brooks RM, Carrington JL, Cheng L, Carrington AC, Porr CA, et al. Effects of pentoxifylline, caffeine, and taurine on post-thaw motility and longevity of equine frozen semen. J Equine Vet Sci. 2013;33:615–21.CrossRef
29.
Stanic P, Sonicki Z, Suchanek E. Effect of pentoxifylline on motility and membrane integrity of cryopreserved human spermatozoa. Int J Androl. 2002;25:186–90.CrossRefPubMed
30.
Ebner T, Tews G, Mayer RB, Ziehr S, Arzt W, Costamoling W, et al. Pharmacological stimulation of sperm motility in frozen and thawed testicular sperm using the dimethylxanthine theophylline. Fertil Steril. 2011;96(6):1331–6.CrossRefPubMed
31.
Simopoulou M, Gkoles L, Bakas P, Giannelou P, Kalampokas T, Pantos K, et al. Improving ICSI: a review from the spermatozoon perspective. Syst Bio Reprod Med. 2016;62:359–71.CrossRef
32.
Kovacic B. Clinical use of pentoxifylline for activation of immotile testicular sperm before ICSI in patients with azoospermia. J Androl. 2006;27:45–52.CrossRefPubMed
33.
Rossato M, Virgilio FD, Foresta C. Involvement of osmo-sensitive calcium influx in human sperm activation. Mol Hum Reprod. 1996;2:903–9.CrossRefPubMed
34.
Stanger JD, Vo L, Yovich JL, Almahbobi G. Hypo-osmotic swelling test identifies individual spermatozoa with minimal DNA fragmentation. Reprod BioMed Online. 2010;21:474–84.CrossRefPubMed
35.
Agameya AF, Sallam HN. The value of sperm velocity, strict morphology and the hypo-osmotic swelling test as predictors of the sperm fertilization potential. Fertil Steril. 2014;101:e8.
36.
Sallam HN, Farrag A, Agameya A-F, El-Garem Y, Ezzeldin F. The use of the modified hypo-osmotic swelling test for the selection of immotile testicular spermatozoa in patients treated with ICSI: a randomized controlled study. Hum Reprod. 2005;20:3435–40.CrossRefPubMed
37.
Check JH, Tubman A, Wilson C. Intracytoplasmic sperm injection allows normal pregnancy rates for males ≥ 40 with low hypo-osmotic swelling test scores even when complicated by very low motility percentage. Fertil Steril. 2011;95:S28.CrossRef
38.
Hossain A, Osuamkpe C, Hossain S, Phelps JY. Spontaneously developed tail swellings (SDTS) influence the accuracy of the hypo-osmotic swelling test (HOS-test) in determining membrane integrity and viability of human spermatozoa. J Assis Reprod Genet. 2009;27:83–6.CrossRef
39.
Soares JB, Glina S, Antunes N, Wonchockier R, Galuppo AG, Mizrahi FE. Sperm tail flexibility test: away to select viable immobile spermatozoa for ICSI. J Urol. 2004;171:363–4.CrossRef
40.
Nordhoff V. How to select immotile but viable spermatozoa on the day of intracytoplasmic sperm injection? An embryologist’s view. Andrology. 2014;3:156–62.CrossRefPubMed
41.
Aktan TM, Montag M, Duman S, Gorkemli H, Rink K, Yurdakul T. Use of a laser to detect viable but immotile spermatozoa. Andrologia. 2004;36:366–9.CrossRefPubMed
42.
Chen H, Feng G, Zhang B, Zhou H, Shu J, Gan X. A successful pregnancy using completely immotile but viable frozen-thawed spermatozoa selected by laser. Clin Exp Reprod Med. 2017;44:52–5.CrossRefPubMedPubMedCentral
43.
Sousa M, Cremades N, Silva J, Oliveira C, Ferraz L, da Silva JT, et al. Predictive value of testicular histology in secretory azoospermic subgroups and clinical outcome after microinjection of fresh and frozen-thawed sperm and spermatids. Hum Reprod. 2002;17:1800–10.CrossRefPubMed
44.
De Croo I, Van der Elst J, Everaert K, De Sutter P, Dhont M. Fertilization, pregnancy and embryo implantation rates after ICSI in cases of obstructive and non-obstructive azoospermia. Hum Reprod. 2000;15:1383–8.CrossRefPubMed
45.
Stein A, Shufaro Y, Hader S, Fisch B, Pinkas H. Successful use of the Cryolock device for cryopreservation of scarce human ejaculate and testicular spermatozoa. Andrology. 2015;3:220–4.CrossRefPubMed
46.
Coetzee K, Ozgur K, Berkkanoglu M, Bulut H, Isikli A. Reliable single sperm cryopreservation in cell sleepers for azoospermia management. Andrologia. 2016;48:203–10.CrossRefPubMed
47.
Bocca S, Moussavi V, Brugh V, Morshedi M, Stadtmauer L, Oehninger S. ICSI outcomes in men undergoing TESE for azoospermia and impact of maternal age. Andrologia. 2017;49:e12617.CrossRef
48.
Mazzilli R, Cimadomo D, Vaiarelli A, Capalbo A, Dovere L, Alviggi E, et al. Effect of the male factor on the clinical outcome of intracytoplasmic sperm injection combined with preimplantation aneuploidy testing: observational longitudinal cohort study of 1,219 consecutive cycles. Fertil Steril. 2017;108:961–72.CrossRefPubMed
49.
Vernaeve V, Tournaye H, Osmanagaoglu K, Verheyen G, Van Steirteghem A, et al. Intracytoplasmic sperm injection with testicular spermatozoa is less successful in men with nonobstructive azoospermia than in men with obstructive azoospermia. Fertil Steril. 2003;79:529–33.CrossRefPubMed
50.
Martin RH, Greene C, Rademaker AW, Ko E, Chernos J. Analysis of aneuploidy in spermatozoa from testicular biopsies from men with nonobstructive azoospermia. J Androl. 2013;24:100–3.
Metadata
Title
Comparison of intracytoplasmic sperm injection outcome with fresh versus frozen-thawed testicular sperm in men with nonobstructive azoospermia: a systematic review and meta-analysis
Authors
Zhe Yu
Zhewen Wei
Jun Yang
Tao Wang
Hongyang Jiang
Hao Li
Zhe Tang
Shaogang Wang
Jihong Liu
Publication date
01-07-2018
Publisher
Springer US
Published in
Journal of Assisted Reproduction and Genetics / Issue 7/2018
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-018-1206-5

Other articles of this Issue 7/2018

Journal of Assisted Reproduction and Genetics 7/2018 Go to the issue

Assisted Reproduction Technologies

Non-O blood group and outcomes of in vitro fertilization

Genetics

A novel mutation in the TUBB8 gene is associated with complete cleavage failure in fertilized eggs

Assisted Reproduction Technologies

Case of successful IVF treatment of an oligospermic male with 46,XX/46,XY chimerism

Assisted Reproduction Technologies

Effect of pre-gravid body mass index on outcomes of pregnancies following in vitro fertilization

Assisted Reproduction Technologies

Compensating human subjects providing oocytes for stem cell research: 9-year experience and outcomes

Commentary

Synergy at work: two heads are better than one