The development of an effective oocyte cryopreservation system will have a significant impact on the clinical practice of reproductive medicine. However, the important option of emergency oocyte cryopreservation has yet to be well documented. In this report, we review the cases of 15 women with male partners who were diagnosed with nonobstructive azoospermia and for whom testicular sperm extraction on the day of oocyte retrieval failed. Emergency oocyte vitrification was performed and after two months, the vitrified oocytes were warmed and the surviving oocytes inseminated with frozen-thawed donor sperm by intracytoplasmic sperm injection (ICSI). A total of 117 mature oocytes from the 15 women were vitrified and warmed. The post-warming survival rate was 84.6% (99/117), and the fertilization rate following ICSI was 83.8% (83/99). We selected 30 embryos for transfer to 15 patients, 8 of whom became pregnant. The clinical pregnancy rate was 53.3% (8/15) and the implantation rate was 30.0% (9/30). Nine healthy live births resulted from 8 pregnancies. These results indicate that emergency oocyte vitrification is an effective rescue technique that can be applied clinically with acceptable pregnancy and live birth rates when testicular sperm extraction from the male partner failed on the day of oocyte retrieval. These results also highlight another important option for oocyte cryopreservation through the use of vitrification technology.

https://www.tandfonline.com/doi/pdf/10.3109/19396368.2011.566666

Clinical outcome of emergency egg vitrification for women when sperm extraction from the testicular tissues of the male partner is not successful.

Fertility Cryopreservation: Testicular tissue cryopreservation

Cryopreservation has no effect on meiotic recombination and synapsis in testicular tissues.

Purpose 
Unexpected sperm retrieval failure on the day of oocyte retrieval is not common but frequently happened in patients with severe oligospermia or non-obstructive azoospermia(NOA). Oocyte cryopreservation is a common strategy after failed collection of sperm when concurrent ovarian stimulation is underwent. However, the use of oocyte vitrification in such male-infertility cases remains unclear.


Objective 
To investigate the outcomes of emergent oocyte cryopreservation after failed sperm retrieval from severe oligospermic or non-obstructive azoospermic (NOA) patients on oocyte retrieval day.


Methods 
Design: Retrospective cohort study

Setting: Academic fertility center at Lee Women's Hospital, Taiwan, between March 2015 and August 2017.

Patients: For 203 couples with NOA(n = 200) or severe oligospermia(n = 3), testicular spermatozoa (n = 67 cycles) or frozen donor sperm (n = 209 cycles) were injected into fresh or frozen-thawed oocytes via 276 intracytoplasmic sperm injection (ICSI) cycles.

Main Outcome Measures: Clinical pregnancy and live-birth rates (LBRs).


Results 
In the 67 cycles involving the use of fresh testicular spermatozoa, no significant differences were observed between fresh and warmed oocytes with respect to the fertilization rates (69.2% vs. 74.1%; p = 0.27), number of Day-3 embryos (8.6±4.4 vs. 6.4±3.4; p = 0.08), number of good-quality Day-3 embryos (4.5±3.9vs. 4.7±3.0; p = 0.45), implantation rates (29.1% vs. 17.8%; p = 0.21), clinical pregnancy rates (36.4% vs. 26.8.0%; p = 0.81), live birth rates (36.4% vs. 14.3%; p = 0.46), or perinatal outcomes. In the 209 cycles involving the use of frozen donor sperm, no significant differences were seen between the two groups, except that the mean birth weights were significantly lower with fresh oocyte pregnancies than with warmed oocytes (2952±196 gm vs 2643±700 gm; p = 0.006).


Conclusions 
Emergent oocyte cryopreservation is a feasible strategy to manage unexpected sperm retrieval failure from severe oligospermic or NOA patients on the oocyte retrieval day. There is no detrimental effect on the live birth rate when testicular spermatozoa or frozen donor sperm are injected into the thawed oocytes compared with fresh oocytes.

/pdf/failed-sperm-retrieval-from-severely-oligospermic-or-non-ghscgnsy34.pdf

Failed sperm retrieval from severely oligospermic or non-obstructive azoospermic patients on oocyte retrieval day: Emergent oocyte cryopreservation is a feasible strategy

The French law regulating assisted reproductive technologies forbids donor spermatozoa to be available in case of failed testicular sperm extraction (TESE) performed on the day of oocyte retrieval. This article reports the first French live birth after intracytoplasmic sperm injection of donated spermatozoa into frozen–thawed oocytes cryopreserved following failure of TESE. By reinforcing the relevance of TESE performed on the day of oocyte retrieval, oocyte cryopreservation in couples having beforehand consented to go to sperm donation will avoid cycle cancellation and potentially lead to successful live birth. Therefore, it could modify the French policy of management of patients suffering from non-obstructive azoospermia.

https://www.rbmojournal.com/article/S1472-6483(12)00143-5/pdf

Oocyte cryopreservation following failed testicular sperm extraction: a French case report with implications for the management of non-obstructive azoospermia

To date, the effects of freezing on spermatogenesis have not yet been fully investigated at a molecular level. Antibody localization studies have identified the MutL homolog 1 (MLH1) protein, a mis-match repair protein, at the prophase I stage of meiosis, which allows the detection of recombination foci during pachytene. This study investigated the effect of long-term testicular tissue cryopreservation on meiotic prophase I, identified by recombination foci frequency and synaptonemal complex (SC) integrity. Frozen–thawed testicular tissues from 12 males who had each fathered a child were used. Because vasectomy or reverse vasectomy procedures are rare in the locale of the investigation, it was not possible to obtain fresh testicular tissue and use the males as their own controls. Immunocytogenetic analysis of 612 spermatocytes at the pachytene stage was performed. The results indicated a mean number of MLH1 foci of 49.2 (SD ± 5.9), and no correlation was found between the freezing period, the MLH1 frequency and the SC integrity. The results suggest that freezing of testicular tissue taken post-puberty does not appear to be detrimental to the crossover process as identified by occurrence of MLH1 loci.

https://www.rbmojournal.com/article/S1472-6483(10)60698-0/pdf

Crossover analysis using immunofluorescent detection of MLH1 foci in frozen-thawed testicular tissue

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Crossover analysis using immunofluorescent detection of MLH1 foci in frozen-thawed testicular tissue