Outcomes of ICSI with microamount frozen-thawed sperm obtained by PESA or TESA in the treatment of azoospermia

OU Lei; GUO Yi-hong; SUN Ying-pu; SU Ying-chun

Abstract：Objective:To investigate the effects and clinical pregnancy outcomes of intracytoplasmic sperm insemination (ICSI) with microamount frozen-thawed sperm obtained by percutaneous epididymal sperm aspiration (PESA) or testicular sperm aspiration (TESA) in azoospermia patients.Methods:We divided 365 azoospermia patients treated by ICSI into an experimental group (n=123) and a control group (n=242),the former with microamount frozen-thawed sperm,and the latter fresh sperm obtained by PESA or TESA.The rates of fertilization,good embryos,clinical pregnancy,miscarriage,ectopic pregnancy and multiple pregnancy were analyzed and compared between the two groups.Results:With PESA,the experimental group showed no statistically significant differences from the control group in the rates of fertilization (75.67% vs 76.49% ),good embryos (64.96% vs 66.09% ),clinical pregnancy (55.21% vs 57.22% ),clinical miscarriage ( 13.21% vs 12.61% ),ectopic pregnancy (3.77% vs 5.41% ) and multiple pregnancy (37.74% vs 37.84% ) ( P＞0.05 ) ; nor with TESA (74.41% vs 76.43 %,64.63 % vs 66.35 %,46.81% vs 53.39%,18.18% vs 14.55%,4.55% vs 1.82%,37.74% vs 37.84%,P＞0.05).The revival rate of the frozen-thawed sperm from PESA was 70.07%,not significantly different from that of TESA(62.67%)(P＞0.05).Conclusion:ICSI with frozen-thawed micro-amount sperm obtained by PESA or TESA is a safe,economic and effective method for the treatment of azoospermia.The techniques for reviving frozen sperm from PESA or TESA remain to be optimized,and whether these techniques may result in long-term genetic risks in the offspring deserves further investigation.