Use of frozen-thawed sperm for ICSI improves fertility outcome in men with azoospermia

Abstract

Özet Amaç: Azospermi tanısı ile mTESE uygulanan hastalarda IVF/ICSI sonuçlarının taze veya dondurulmuş-çözülmüş testis spermi ile karşılaştırılması. Gereç ve yöntem: Bu retrospektif kohort çalışması, Memorial ve BAU Tüp Bebek Merkezlerine 2017-2020 yılları arasında azospermi tanısıyla başvuran ve taze veya dondurulmuş testis spermi kullanılarak cerrahi sperm ekstraksiyonu ve ICSI uygulanan 260 infertil erkek üzerinde gerçekleştirildi. Hastalar belirtildiği gibi iki eşit gruba ayrıldı. Grup 1 (n = 130), ICSI ve ardından taze testis spermi kullanılarak embriyo transferi yapılan hastalardan oluşuyordu. Grup 2 (n = 130); donmuş çözdürülmüş testis spermi kullanılarak ICSI uygulanan hastalardan oluşuyordu. Çalışmamızın temel amacı dondurulmuş veya taze testis spermi kullanılarak ICSI/ET uygulanan her iki gruptaki hastaları klinik gebelik ve canlı doğum oranları açısından karşılaştırmaktır. Ek olarak, her iki grup hem demografik hem de diğer üreme parametreleri açısından karşılaştırıldı. Bulgular: Taze sperm grubundaki hastaların total oosit, M II oosit ve 2 PN embriyo sayıları, dondurulmuş sperm grubuna göre anlamlı olarak yüksek bulundu (p <.000). Taze sperm grubunda klinik gebelik oranı 25 olguda (% 19,8) tespit edilirken, 101 olguda (% 80,2) gebelik saptanmadı. Dondurulmuş çözülmüş sperm grubunda 66 vakada (% 50,8) klinik gebelik tespit edilirken, 64 vakada (% 49,2) gebelik tespit edilmedi. Dondurulmuş sperm ile ICSI/ET uygulanan hastalarda klinik gebelik oranları taze sperm grubuna göre anlamlı olarak daha yüksek bulundu (% 50,8'e karşı% 19,8, p <.000). Benzer şekilde, dondurulmuş sperm ile ICSI/ET yapılan grupta canlı doğum oranları, taze sperm grubuna göre anlamlı olarak daha yüksek bulundu (% 3.2'ye karşı% 41.9, p <.00). Sonuç: Azospermili erkeklerde ICSI/ET için dondurulmuş-çözülmüş testis spermi kullanımı, taze testis sperm ile yapılan ICSI sikluslarından daha iyi klinik gebelik ve canlı doğum oranları sağlayabilir. Abstract Aim: To compare the results of IVF/ICSI outcomes with fresh or frozen-thawed testicular sperm in patients who underwent mTESE with the diagnosis of azoospermia. Materials and Methods: This retrospective cohort study was conducted on 260 infertile men who applied to the Memorila IVF-Center with the diagnosis of azoospermia between 2017 and 2020 and underwent surgical sperm extraction and ICSI using fresh or frozen testicular sperm. The patients were divided into two equal groups as indicated. Group 1 (n = 130) consisted of patients who underwent ICSI and subsequent embryo transfer using fresh testicular sperm. Group 2 (n = 130); consisted of patients who underwent ICSI by using frozen-thawed testicular sperm. Primary outcome was clinical pregnacy rates (CPR) and live birth rates (LBR). Patients in both groups who underwent ICSI/ET using frozen or fresh testicular sperm were compared in terms of clinical pregnancy and live birth rates. In addition, both groups were compared in terms of both demographic and other reproductive parameters. Results: The total oocyte, M II oocyte and 2 PN embryo counts of the patients in the fresh sperm group were found to be significantly higher than the frozen sperm group (p <.000). In the fresh sperm the clinical pregnancy rate was detected in 25 cases (19.8%), while no pregnancy was detected in 101 cases (80.2%). In the frozen-thawed sperm group the clinical pregnancy was detected in 66 cases (50.8%), whereas pregnancy was not detected in 64 cases (49.2%). Clinical pregnancy rates were found to be significantly higher in patients who underwent ICSI/ET with frozen sperm compared to fresh sperm group (50.8% vs 19.8%, p<.000). Similarly, live birth rates were found to be significantly higher in the frozen sperm and ICSI/ET group compared to the fresh sperm group (3.2% vs 41.9%, p<.00). Conclusion: Use of frozen-thawed testicular sperm for ICSI/ET in men with azoospermia may provide better clinical pregnancy and live birt rates than ICSI cycles with fresh testicular sperm.

Keywords

• fresh sperm
• frozen sperm
• ICSI
• azoospermia
• fertility outcome

Project Number

yok

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