Outcomes After Testicular Aspiration and Testicular Tissue Cryopreservation for Obstructive Azoospermia and Ejaculatory Dysfunction

Purpose

We examined the rate of successful sperm retrieval, fertilization, pregnancy and live births in patients with obstructive azoospermia and ejaculatory dysfunction who underwent testicular sperm aspiration in conjunction with in vitro fertilization/intracytoplasmic sperm injection using cryopreserved testicular tissue.

Materials and Methods

We retrospectively reviewed the records of 40 couples who underwent testicular sperm aspiration from August 2003 to November 2007. All procedures were performed before intracytoplasmic sperm injection with the goal of tissue cryopreservation.

Results

Mature sperm was successfully retrieved and cryopreserved in 39 of 40 patients (97%) with an average of 5 vials cryopreserved per couple. Of the women 34 underwent in vitro fertilization/intracytoplasmic sperm injection and in 5 treatment was planned. The fertilization rate was 58% with a pregnancy rate of 61.4% (27 of 44 cycles). There were 17 live births, 5 ongoing pregnancies and 5 miscarriages. No complications were noted and all patients returned to full activity within 2 to 3 days.

Conclusions

Testicular sperm aspiration with cryopreservation is a safe and effective sperm retrieval method in patients with obstructive azoospermia and ejaculatory dysfunction when in vitro fertilization/intracytoplasmic sperm injection will be performed.

Key Words: testis, sperm retrieval, azoospermia, cryopreservation, fertilization in vitro

Abbreviations and Acronyms: ICSI, intracytoplasmic sperm injection, IVF, in vitro fertilization, OA, obstructive azoospermia, PESA, percutaneous epididymal sperm aspiration, TESA, testicular sperm aspiration, TESE, testicular sperm extraction