{
    "abstract": "Besides non-obstructive azoospermia, other conditions also benefit from the use of testicular sperm extraction, but their clinical outcomes remain to be explored in detail.\nTo compare the use of fresh and frozen testicular spermatozoa in patients submitted to testicular sperm extraction because of idiopathic or secondary non-obstructive azoospermia, and after recurrent failed intracytoplasmic sperm injection attempts using ejaculated or aspirated testicular spermatozoa.\nWe retrospectively evaluated 325 patients with normal karyotypes and absence of Y-chromosome microdeletions that used testicular sperm extraction for fertility treatments. Comparisons included detailed embryological, clinical, and newborn outcomes.\nPatients underwent 503 treatment cycles, 269 with fresh and 234 with frozen testicular spermatozoa. No significant differences were observed between fresh and frozen spermatozoa regarding clinical pregnancy (38.0%/43.2%), live birth delivery (32.2%/34.0%), and newborn (40.1%/43.2%) rates, the same being observed in cumulative clinical pregnancy (47.9%/48.5%), live birth delivery (41.7%/38.3%), and newborn (50.4%/48.5%) rates. Also, no significant differences were observed between fresh and frozen spermatozoa per pathology (idiopathic or secondary non-obstructive azoospermia, cryptorchidism, abnormal semen parameters, cryptozoospermia, obstructive azoospermia, and anejaculation). However, in idiopathic non-obstructive azoospermia, frozen embryo transfer cycles from fresh sperm cycles evidenced significantly higher rates of live birth delivery and newborn. As cycles with frozen spermatozoa evidenced significantly higher female age, time of infertility, and basal follicle stimulating hormone, and significantly lower number of follicles, female characteristics were thereafter individualized. The presence of mixed factors did not affect outcomes. Good ovarian response cases exhibited significantly higher rates of implantation and newborn, whereas younger women cases showed significantly higher rates of implantation, clinical pregnancy, and newborn; however, when fresh spermatozoa were compared to frozen spermatozoa, these differences were no longer present.\nData provide detailed embryological, clinical, and newborn outcomes associated with specific conditions in which testicular sperm extraction was required. It also highlights no detrimental effects on outcomes when frozen testicular spermatozoa is used.",
    "authors": [
        {
            "affiliation": "Laboratory of Cell Biology, Department of Microscopy, Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Universidade do Porto, Porto, Portugal.\nUnit for Multidisciplinary Investigation in Biomedicine/ITR-Laboratory for Integrative and Translational Research in Population Health, University of Porto, Porto, Portugal.\nUnidade Local de Sa\u00fade de Santo Ant\u00f3nio, Porto, Portugal.",
            "firstname": "Mariana",
            "initials": "M",
            "lastname": "Pereira"
        },
        {
            "affiliation": "Centre for Reproductive Genetics Alberto Barros, Porto, Portugal.",
            "firstname": "Mariana",
            "initials": "M",
            "lastname": "Cunha"
        },
        {
            "affiliation": "Centre for Reproductive Genetics Alberto Barros, Porto, Portugal.",
            "firstname": "Joaquina",
            "initials": "J",
            "lastname": "Silva"
        },
        {
            "affiliation": "Centre for Reproductive Genetics Alberto Barros, Porto, Portugal.",
            "firstname": "Paulo",
            "initials": "P",
            "lastname": "Viana"
        },
        {
            "affiliation": "Centre for Reproductive Genetics Alberto Barros, Porto, Portugal.",
            "firstname": "Nuno",
            "initials": "N",
            "lastname": "Barros"
        },
        {
            "affiliation": "Centre for Reproductive Genetics Alberto Barros, Porto, Portugal.",
            "firstname": "Jos\u00e9 Teixeira",
            "initials": "JT",
            "lastname": "da Silva"
        },
        {
            "affiliation": "Centre for Reproductive Genetics Alberto Barros, Porto, Portugal.",
            "firstname": "Cristiano",
            "initials": "C",
            "lastname": "Oliveira"
        },
        {
            "affiliation": "Department of Urology, Unidade Local de Sa\u00fade de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.",
            "firstname": "Lu\u00eds",
            "initials": "L",
            "lastname": "Ferraz"
        },
        {
            "affiliation": "Centre for Reproductive Genetics Alberto Barros, Porto, Portugal.\nDepartment of Pathology, Unit of Genetics, Faculty of Medicine, University of Porto, Porto, Portugal.\nRISE-Health Research Network, University of Porto, Porto, Portugal.",
            "firstname": "Alberto",
            "initials": "A",
            "lastname": "Barros"
        },
        {
            "affiliation": "Laboratory of Cell Biology, Department of Microscopy, Instituto de Ci\u00eancias Biom\u00e9dicas Abel Salazar, Universidade do Porto, Porto, Portugal.\nUnit for Multidisciplinary Investigation in Biomedicine/ITR-Laboratory for Integrative and Translational Research in Population Health, University of Porto, Porto, Portugal.",
            "firstname": "M\u00e1rio",
            "initials": "M",
            "lastname": "Sousa"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2025 American Society of Andrology and European Academy of Andrology.",
    "doi": "10.1111/andr.70041",
    "journal": "Andrology",
    "keywords": [
        "clinical outcomes",
        "fresh and frozen spermatozoa",
        "idiopathic azoospermia",
        "intracytoplasmic sperm injection",
        "newborn outcomes",
        "testicular sperm extraction"
    ],
    "methods": null,
    "publication_date": "2025-04-12",
    "pubmed_id": "40220340",
    "results": "Patients underwent 503 treatment cycles, 269 with fresh and 234 with frozen testicular spermatozoa. No significant differences were observed between fresh and frozen spermatozoa regarding clinical pregnancy (38.0%/43.2%), live birth delivery (32.2%/34.0%), and newborn (40.1%/43.2%) rates, the same being observed in cumulative clinical pregnancy (47.9%/48.5%), live birth delivery (41.7%/38.3%), and newborn (50.4%/48.5%) rates. Also, no significant differences were observed between fresh and frozen spermatozoa per pathology (idiopathic or secondary non-obstructive azoospermia, cryptorchidism, abnormal semen parameters, cryptozoospermia, obstructive azoospermia, and anejaculation). However, in idiopathic non-obstructive azoospermia, frozen embryo transfer cycles from fresh sperm cycles evidenced significantly higher rates of live birth delivery and newborn. As cycles with frozen spermatozoa evidenced significantly higher female age, time of infertility, and basal follicle stimulating hormone, and significantly lower number of follicles, female characteristics were thereafter individualized. The presence of mixed factors did not affect outcomes. Good ovarian response cases exhibited significantly higher rates of implantation and newborn, whereas younger women cases showed significantly higher rates of implantation, clinical pregnancy, and newborn; however, when fresh spermatozoa were compared to frozen spermatozoa, these differences were no longer present.",
    "title": "Embryological, clinical, and newborn outcomes from 583 treatment cycles with fresh and frozen testicular spermatozoa.",
    "xml": "<Element 'PubmedArticle' at 0x7885049bca40>"
}