BERKELEY, CA (UroToday.com) - This is a retrospective study assessing the Fertilization, implantation, and pregnancy rates in 158 patients who underwent 61 cycles of ICSI with cryopreserved and 79 cycles of ICSI with fresh spermatozoa. The authors report that normal-fertilization rates were higher using fresh sperm (73.8%) compared with cryopreserved sperm (68.7%). Cycles performed in patients with normozoospermia or oligozoospermia had similar fertilization, implantation, and pregnancy rates using fresh or cryopreserved sperm. However, fertilization rates were higher using fresh asthenozoospermic and oligoasthenozoospermic samples than frozen asthenospermic or oligospermic samples. However, implantation and pregnancy rates were similar.

Editorial Comment:
This issue of utilizing fresh versus frozen sperm for IVF cycles, continues to be debated more commonly in the setting of testicular or epididymal sperm.

When fresh ejaculated specimens are readily available, they are, in general, the preferred source. That being said there are circumstances when fresh sperm may not be available for medical reasons or are not available for social reasons. Fresh ejaculated sperm may not be available after vasectomy or therapy for malignancies. In either of these situations sperm may have been cryopreserved pior to the intervention. Fresh ejaculated sperm may not be available because of ejaculatory dysfunction or job related travel. In either case, it is important to know what the impact would be of using cryopreserved sperm. The current study indicates that in cases of normal spermatogenesis, there was no impact - fertilization and pregnancy rates were similar. Abnormal sperm (asthenozoospermic and oligoasthenospermic) are more susceptible to damage as evidenced by the lower fertilization rate. However, implantation rates, pregnancy rates and miscarriage rates were similar.

The current study does not address the clinical dilemma that urologists and reproductive endocrinologists are more likely to face. Is there a difference between fresh and cryopreserved testicular sperm? However, it does support the utilization of cryopreserved ejaculated sperm for ICSI.

Borges Jr. E, Rossi LM, Locambo de Freitas CV, Guilherme P, Bonetti TCS, Iaconelli A, Pasqualotto FF

Fertility and Sterility: 87(2): 316-320, 2007

Written by Harris M. Nagler, MD, a Contributing Editor with UroToday.

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