Korean J Obstet Gynecol.  2004 Nov;47(11):2167-2172.

Pregnancy Outcomes after Transfer of Frozen-thawed Embryos following ICSI with Ejaculated, Fresh and Frozen-thawed Testicular Sperm

• Kim SK
• Byun HK
• Choi SJ
• Park YS
• Song SJ
• Jun JH
• Koong MK
• Song IO
• Yoo KJ
• Yang KM
• Kim JY
• Seo JT
• Kang IS

Abstract

OBJECTIVES
This study was performed to evaluate the pregnancy rate following the transfers of frozen- thawed embryos which was derived from intracytoplasmic sperm injection (ICSI) using sperm obtained by ejaculated, testicular sperm extraction (TESE), and frozen-thawed testicular sperm extraction (t-TESE).
METHODS
Frozen-thawed embryos were successfully transferred to the patients in 664 cycles among 695 cycles from January 1998 to December 2002, where ICSI was done with various origins of sperm. Subjects were divided into three groups according to the origin of sperm; ejaculated sperm group as a control (n=535), TESE group (n=98) and t-TESE group (n=62). After conventional ICSI, the supernumerary PN stage or developing embryos were cryopreserved by slow freezing protocol with 1, 2-propanediol as cryoprotectant.
RESULTS
The survival rate of frozen-thawed embryos was 77.7% (2515/3236) in ejaculated sperm group, 76.6% (441/576) in TESE group and 83.9% (292/348) in frozen-thawed TESE group, respectively. The difference of survival rate of between t-TESE group and other two groups was statistically significant (p<0.01). The good embryo formation rate and positive beta-hCG rate was 46.3% (1164/2515), 28.8% (148/513) in ejaculated sperm group, 49.2% (217/441), 36.6% (34/93) in TESE group and 46.2% (135/292), 34.9% (22/63) in frozen-thawed TESE group, respectively.
CONCLUSION
This study demonstrates that comparable pregnancy rate and implantation rate could be achieved after the transfer of frozen-thawed embryos following ICSI using various sources of sperm. As there was no statistically significant difference in pregnacy rate between ICSI with fresh testicular sperm and with frozen-thawed testicular sperm, the sequential cryopreservation of supernumerary testicular sperm and embryos may be a useful method for increasing pregnancy outcome in infertile couples with male factor.

Keyword

Cryopreservation; ICSI; TESE; t-TESE; Frozen-thawed ET

MeSH Terms

Cryopreservation
Embryonic Structures*
Family Characteristics
Female
Freezing
Humans
Male
Pregnancy
Pregnancy Outcome*
Pregnancy Rate
Pregnancy*
Sperm Injections, Intracytoplasmic*
Spermatozoa*
Survival Rate