Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
Outcome of anticipated ICSI cycles using intentionally frozen-thawed testicular spermatozoa according to the spouse's response to ovarian stimulation
Purpose: To investigate the outcome of ICSI cycles, using frozen-thawed testicular spermatozoa from patients suffering from nonobstructive azoospermia, in relation to the spouse's response to ovarian stimulation. Methods: A retrospective study with two groups of couples where males suffered from non-obstructive azoospermia. In group 1 (n = 14), the female partners responded poorly to ovarian stimulation (S 4 oocytes retrieved). In group 2 (n=14), the female partners responded well (>10 oocytes retrieved). Both groups underwent 14 cycles of ICSI using frozen-thawed spermatozoa obtained by TESE. Results: The total amount of gonadotropin, the duration of stimulation, the peak estradiol concentrations and the number of oocytes were significantly different between the two groups. Despite the satisfactory fertilisation rates, the outcome in poor responders was disappointing due to a low number of oocytes. There was only one pregnancy in the poor responder group whereas there were four in the group that responded well. The pregnancy rates per oocyte collection were 7.14% in group 1 versus 28.57% in group 2. The implantation rates were 60.60% versus 55.33%, respectively. Conclusion: It is possible to achieve satisfactory fertilisation rates using frozen-thawed, surgically-retrieved testicular spermatozoa, but the poor ovarian response to stimulation induction is the limiting factor in reaching implantation and pregnancy. It is preferable that poorly stimulated cycles be canceled, in the hope of a better subsequent response.