Impact on using cryopreservation of testicular or epididymal sperm upon intracytoplasmic sperm injection outcome in men with obstructive azoospermia: a systematic review and meta-analysis

Purpose To determine whether there was a significant impact on using cryopreservation of testicular or epididymal sperm upon the outcomes of intracytoplasmic sperm injection (ICSI) in patients with obstructive azoospermia (OA). Method Systematic review and meta-analysis of 20 retrospective studies i...

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Published in:Journal of assisted reproduction and genetics 2020-11, Vol.37 (11), p.2643-2651
Main Authors: Liu, Hanchao, Xie, Yun, Gao, Linzhi, Sun, Xiangzhou, Liang, Xiaoyan, Deng, Chunhua, Gao, Yong, Liu, Guihua
Format: Article
Language:English
Subjects:
Cryogenic engineering
Cryopreservation
Fertilization
Gynecology
Human Genetics
Injection
Medicine
Medicine & Public Health
Meta-analysis
Oocytes
Pregnancy
Reproductive Medicine
Review
Sperm
Systematic review
Testes
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Summary:Purpose To determine whether there was a significant impact on using cryopreservation of testicular or epididymal sperm upon the outcomes of intracytoplasmic sperm injection (ICSI) in patients with obstructive azoospermia (OA). Method Systematic review and meta-analysis of 20 retrospective studies in databases from January 1, 1995, to June 1, 2020. Result Twenty articles were included in this study. A total of 3602 (64.1%) of 5616 oocytes injected with fresh epididymal sperm were fertilized, compared with 2366 (61.2%) of 3862 oocytes injected with cryopreserved sperm (relative risk ratio (RR) 0.96, 95% confidence interval (CI) (0.90, 1.02), P > 0.05). A total of 303 (44.1%) of 687 ICSI cycles using fresh epididymal sperm resulted in a clinical pregnancy, compared with 150 (36.6%) of 410 ICSI cycles using cryopreserved epididymal sperm (RR 0.84, 95% CI (0.72, 0.97), P < 0.05). In the testis, a total of 2147 (68.7%) of 3125 oocytes injected with fresh sperm were fertilized, compared with 1623 (63.5%) of 2557 oocytes injected with cryopreserved sperm (RR 0.97, 95% CI (0.90, 1.06), P > 0.05). A total of 151 (47.8%) of 316 ICSI cycles using fresh testicular sperm resulted in a clinical pregnancy, compared with 113 (38.2%) of 296 ICSI cycles using cryopreserved sperm (RR 0.87, 95% CI (0.72, 1.05), P > 0.05). Conclusions In men with OA, there was a statistical lower clinical pregnancy rate (CPR) by using frozen epididymal sperm compared with fresh epididymal sperm, but showing no difference on fertilization rate (FR). Additionally, FR and CPR were not affected by whether the retrieved testicular sperm was frozen or fresh.
ISSN:1058-0468
1573-7330
DOI:10.1007/s10815-020-01940-1