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Abstract

Volume 24, Issue 5 (September 2022) 24, 533–539; 10.4103/aja2021101

Clinical benefits of a modified Cryopiece system for cryopreservation of rare ejaculated and testicular spermatozoa for ICSI

Wei Chen1, Chuan Huang1,2, Peng Li1, Feng Liu1, Jian Sun1, Zi-Jue Zhu1, Jing Zhai1, Yuan Xu1, Yan Hong1, Jian-Lin Hu1, Yun-Peng Peng3, Zhen-Bo Zhang1, Yu Wu1, Zheng Li1

1 Department of ART, Department of Andrology, Center for Men's Health, Institute of Urologic Medical Center, Shanghai General Hospital, Shanghai Key Lab of Reproductive Medicine, Shanghai Jiao Tong University, Shanghai 200080, China
2 Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410000, China
3 Department of Urology, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, China

Correspondence: Dr. Z Li (lizhengboshi@sjtu.edu.cn) or Dr. Y Wu (wuyu1970@yahoo.com)

Date of Submission 04-Jun-2021 Date of Acceptance 11-Nov-2021 Date of Web Publication 21-Jan-2022

Abstract

Cryopreservation of rare testicular-retrieved spermatozoa for intracytoplasmic sperm injection (ICSI) in patients with severe oligozoospermia and azoospermia remains a major challenge in clinical practice. This study evaluated the Cryopiece system as a potential technique to cryopreserve rare human spermatozoa for ICSI. Small numbers of ejaculated (24 patients) and testicular (13 patients) spermatozoa were cryopreserved using the Cryopiece system. The total number of recovered spermatozoa and motility were assessed after thawing. Thirty-seven couples underwent ICSI using spermatozoa cryopreserved by the Cryopiece system, and ICSI outcomes (rates of fertilization, embryo cleavage, and clinical pregnancy) were evaluated. The average sperm post-thaw retrieval rate was 79.1%, and motility was 29.7%. Ejaculated spermatozoa had a higher post-thaw motility (32.5%) than testicular spermatozoa (21.8%; P = 0.005). ICSI achieved a fertilization rate of 61.9%, embryo cleavage rate of 84.6%, and clinical pregnancy rate of 43.3%. The ICSI outcomes in the ejaculated and testicular frozen-thawed spermatozoa were similar. Assisted oocyte activation (AOA) after ICSI with motile (72.1%) or immotile (71.9%) spermatozoa resulted in a significantly higher fertilization rate than that when using motile spermatozoa without AOA (52.0%; P = 0.005). However, AOA did not enhance the clinical pregnancy rate (55.6% or 40.0% vs 35.3%; P = 0.703). The Cryopiece system is simple and useful for the cryopreservation of small numbers of ejaculated or testicular spermatozoa for ICSI in patients with severe oligozoospermia or nonobstructive azoospermia.

Keywords: Cryopiece system; intracytoplasmic sperm injection outcome; rare sperm cryopreservation

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