Successful Delivery Derived from Vitrified-warmed Spermatozoa from a Patient with Nonobstructive Azoospermia

Objective: To report the clinical outcomes following intracytoplasmic sperm injection (ICSI) with vitrified sperm from patients with severe male factor infertility.

Design: Retrospective case series.

Setting: IVF unit of a medical center.

Patient(s): Three patients with severe oligozoospermia or nonobstructive azoospermia (NOA).

Intervention(s): Cryopreservation of limited numbers of spermatozoa with the use of Cryotop and Cell Sleeper as nonbiologic containers.

Main Outcome Measure(s): Four cycles underwent intracytoplasmic sperm injection (ICSI) with vitrified sperm.

Result(s): A total of 148 spermatozoa in 18 containers (8.2 sperm per container) were vitrified and 36 of them (5 containers) were warmed. Thirty-three sperm (92%) were retrieved successfully and injected individually into 17 mature oocytes. Fertilization was observed in 12 oocytes (71%), and all zygotes (100%) cleaved. A couple with NOA achieved a singleton pregnancy and concluded with full-term delivery of a healthy boy (2,632 g).

Conclusion(s): A successful delivery was achieved after transfer of a blastocyst derived from vitrified-warmed spermatozoa. A small number of vitrified sperm cells were used for ICSI to fertilize oocytes with predictable timing.