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Volume 28, Issue 3 (May 2026) 28, 321–326; 10.4103/aja202592
No difference in ICSI outcomes from cryopreserved testicular spermatozoa from patients with azoospermia or cryptozoospermia
Xu, Jin-Yan1,2; Li, Ding-Ming1,2; Liu, Bo1,2; Liu, Sha-Sha1,2; Luo, Xue-Feng1,2; Luo, Chen1,2; Zhao, Wen-Rui1,2; Liu, Yuan1,2; Ying, Li-Juan1,2; Xian, Yang1,2; Li, Fu-Ping1,2
1Department of Reproductive Andrology & Sichuan Human Sperm Bank, West China Second University Hospital, Sichuan University, Chengdu 610041, China
2Key Laboratory of Birth Defects and Related Disease of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, China
Correspondence: Dr. Y Xian (406336616@qq.com) or Dr. FP Li (lfpsnake@scu.edu.cn)
Received: 29 June 2025; Accepted: 23 October 2025; published online: 03 March 2026
| Abstract |
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Intracytoplasmic sperm injection (ICSI) with cryopreserved testicular spermatozoa retrieved via testicular sperm aspiration (TESA) or microdissection testicular sperm extraction (micro-TESE) is an effective treatment for azoospermia and cryptozoospermia. The current research on testicular sperm cryopreservation has primarily focused on comparing ICSI outcomes between fresh and frozen-thawed testicular spermatozoa. Another focus of these researches is evaluating treatment efficacy differences between ICSI using spermatozoa from patients with obstructive azoospermia (OA) versus non-obstructive azoospermia (NOA). However, few studies have investigated ICSI outcomes among patients with OA, NOA, and cryptozoospermia. This retrospective cohort study analyzed the data from 688 patients at Sichuan Human Sperm Bank (Chengdu, China) between September 2021 and April 2024, comparing cryopreservation efficacy, sperm utilization rate, ICSI outcomes, and delivery outcomes of cryopreserved testicular sperm suspensions in OA group (n = 542), NOA group (n = 114), and cryptozoospermia group (n = 32). Post-thaw analysis revealed that the median sperm viability before and after freezing, as well as the viability ratio, did not differ among the three groups (all P > 0.05). Sperm utilization in NOA group (60.5%) was significantly higher (both P < 0.0001) compared with cryptozoospermia group (31.3%) and OA group (19.9%), while no significant difference was found between OA and cryptozoospermia groups (P > 0.05). Of 162 couples undergoing ICSI, there were no differences in fertilization, clinical pregnancy, delivery, and miscarriage rates among patients with OA, NOA, and cryptozoospermia (all P > 0.05). In the cryptozoospermia group with five newborns, all were full-term with normal birth weights, but this group had the highest maternal pregnancy complication rate.
Keywords: cryptozoospermia; intracytoplasmic sperm injection; non-obstructive azoospermia; obstructive azoospermia; testicular
sperm cryopreservation
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