INTRODUCTION AND OBJECTIVES: Cryopreserved sperm offers several advantages, including the ability to schedule procedures electively and to know whether or not sperm is available for artificial reproductive techniques. However, technicians are often reluctant to use cryopreserved sperm. We sought to determine if pregnancy outcomes of cryopreserved sperm for intracytoplasmic sperm injection (ICSI) in patients with nonobstructive azoopermia (NOA) are similar to those of fresh sperm. METHODS: We conducted a systematic review and metaanalysis of the data from the literature using the key words oligospermia, azoospermia, nonobstructive, pregnancy, needle, fine needle, froz*, freez*, or cryopreserv*. A total of 224 studies were identified, 11 of which met criteria. Inclusion criteria included human studies with nonobstructive azoospermic patients using testicular sperm, and clinical pregnancies as an outcome. Pregnancy outcomes were extracted and pooled. Summary risk estimates were performed and a power analysis determined that pbeta<10% for outcomes ensuring that our chance of a Type II error was acceptably low. RESULTS: Eleven studies met criteria for clinical pregnancy. Ninety of 341 (26.4%) ICSI cycles of frozen thawed testicular sperm resulted in clinical pregnancy versus 79 of 275 (28.7%) ICSI cycles of fresh sperm with p=0.91, RR of 0.98 (95% CI 0.74, 1.31). CONCLUSIONS: The use of frozen thawed testicular sperm for assisted reproduction was shown to have no clinical or statistical significance in pregnancy outcomes for patients with nonobstructive azoospermia compared with the use of fresh sperm. Given equivalent efficacy for clinical pregnancy rates, frozen thawed sperm may safely allow simpler coordination between testicular sperm extraction and its ICSI cycle.
Ohlander, S., Hotaling, J., Kirshenbaum, E., Niederberger, C., & Eisenberg, M. L. (2013). 1891 THE IMPACT OF FRESH VERSUS FROZEN TESTICULAR SPERM UPON INTRACYTOPLASMIC SPERM INJECTION (ICSI) PREGNANCY OUTCOMES IN MEN WITH NONOBSTRUCTIVE AZOOSPERMIA (NOA): A META ANALYSIS. Journal of Urology, 189(4S). https://doi.org/10.1016/j.juro.2013.02.2310