Article| Volume 44, ISSUE 2, P333-339, February 2022

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Comparison of fresh and frozen ejaculated spermatozoa in sibling oocyte recipient cycles

Published:October 03, 2021DOI:


      Research question

      Do IVF and intracytoplasmic sperm injection cycles using fresh and frozen ejaculated spermatozoa result in similar pregnancy outcomes in couples with non-male factor infertility?


      Retrospective cohort study; patients undergoing donor egg recipient cycles, in which oocytes from a single ovarian stimulation were split between two recipients, were reviewed. Two recipients of oocytes from a single donor were paired and categorized based on the type of ejaculated spermatozoa (fresh/frozen). Outcomes included delivery rate, implantation, pregnancy, pregnancy loss and fertilization rates.


      Of the 408 patients who received oocytes from a split donor oocyte cycle, 45 pairs of patients used discrepant types of ejaculated spermatozoa and were included in the study. Fertilization rate: fresh (74.8%); frozen (68.6%) (P = 0.13). Pregnancy rate: fresh (76%); frozen (67%); delivery rate: fresh (69%); frozen (44%); implantation rate was significantly higher: fresh (64%); frozen (36%) (P = 0.04). Rate of pregnancy loss was significantly higher in the frozen group compared with the fresh group (33% versus 5.9%, P = 0.013). Adjusted odds for delivery was 67% lower in the frozen group (95% CI 0.12, 0.89). Adjusted odds of pregnancy (adjusted OR 0.67, 95% CI 0.20, 2.27) and implantation (adjusted OR 0.5, 95% CI 0.12, 2.12) were not significantly different between the frozen and fresh sperm groups.


      In this model that controls for oocyte quality by using paired recipients from the same donor, frozen ejaculated spermatozoa resulted in lower delivery rates than those using fresh spermatozoa


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      Dr Steven Spandorfer is Associate Professor of Obstetrics and Gynecology and Reproductive Medicine at the Ronald O Perelman and Claudia Cohen Center for Reproductive Medicine at Weill Cornell Medical College. A renowned reproductive medicine specialist, he is board certified in both obstetrics and gynaecology and reproductive endocrinology and infertility.
      Key message
      IVF and intracytoplasmic sperm injection (ICSI) cycles using frozen ejaculated spermatozoa results in poorer pregnancy outcomes compared with cycles using fresh ejaculated spermatozoa in couples with non-male factor infertility. Our study suggests that fresh ejaculated spermatozoa may be preferable in IVF-ICSI cycles in patients with non-male factor infertility.