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

Ozet Amac: Azospermi tanisi ile mTESE uygulanan hastalarda IVF/ICSI sonuclarinin taze veya dondurulmus-cozulmus testis spermi ile karsilastirilmasi. Gerec ve yontem: Bu retrospektif kohort calismasi, Memorial ve BAU Tup Bebek Merkezlerine 2017-2020 yillari arasinda azospermi tanisiyla basvuran ve taze veya dondurulmus testis spermi kullanilarak cerrahi sperm ekstraksiyonu ve ICSI uygulanan 260 infertil erkek uzerinde gerceklestirildi. Hastalar belirtildigi gibi iki esit gruba ayrildi. Grup 1 (n = 130), ICSI ve ardindan taze testis spermi kullanilarak embriyo transferi yapilan hastalardan olusuyordu. Grup 2 (n = 130); donmus cozdurulmus testis spermi kullanilarak ICSI uygulanan hastalardan olusuyordu. Calismamizin temel amaci dondurulmus veya taze testis spermi kullanilarak ICSI/ET uygulanan her iki gruptaki hastalari klinik gebelik ve canli dogum oranlari acisindan karsilastirmaktir. Ek olarak, her iki grup hem demografik hem de diger ureme parametreleri acisindan karsilastirildi. Bulgular: Taze sperm grubundaki hastalarin total oosit, M II oosit ve 2 PN embriyo sayilari, dondurulmus sperm grubuna gore anlamli olarak yuksek bulundu (p <.000). Taze sperm grubunda klinik gebelik orani 25 olguda (% 19,8) tespit edilirken, 101 olguda (% 80,2) gebelik saptanmadi. Dondurulmus cozulmus sperm grubunda 66 vakada (% 50,8) klinik gebelik tespit edilirken, 64 vakada (% 49,2) gebelik tespit edilmedi. Dondurulmus sperm ile ICSI/ET uygulanan hastalarda klinik gebelik oranlari taze sperm grubuna gore anlamli olarak daha yuksek bulundu (% 50,8'e karsi% 19,8, p <.000). Benzer sekilde, dondurulmus sperm ile ICSI/ET yapilan grupta canli dogum oranlari, taze sperm grubuna gore anlamli olarak daha yuksek bulundu (% 3.2'ye karsi% 41.9, p <.00). Sonuc: Azospermili erkeklerde ICSI/ET icin dondurulmus-cozulmus testis spermi kullanimi, taze testis sperm ile yapilan ICSI sikluslarindan daha iyi klinik gebelik ve canli dogum oranlari saglayabilir. 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.