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Resumen Introduccion A pesar de las ventajas que presenta la criopreservacion de espermatozoides testiculares, los datos que refleja la bibliografia acerca de los resultados obtenidos, son bastante contradictorios. Objetivos El objetivo de este trabajo es la optimizacion de los resultados del ICSI ( intra-cytoplasmatic sperm injection ) basandose en el metodo de procesamiento de los espermatozoides de testiculo congelados y descongelados. Metodos Se realizaron 60 biopsias de testiculo en varones diagnosticados de azoospermia obstructiva, y se aislaron espermatozoides que se criopreservaron. Se realizaron un total de 90 ciclos de ICSI. Los grupos de estudio fueron: grupo 1 (control) (n = 20), los espermatozoides testiculares en fresco se incubaron durante 4 h antes del ICSI; grupo 2 (n = 34), los espermatozoides testiculares se incubaron durante 4-6 h antes de la criopreservacion y se utilizaron para ICSI las muestras descongeladas, y grupo 3 (n = 38), los espermatozoides testiculares empleados para ICSI se incubaron durante 4-6 h despues de la descongelacion. En los 3 grupos se compararon: tasa de fecundacion, tasa de division, calidad embrionaria, tasa de gestacion e implantacion. Resultados La movilidad de los espermatozoides aumentaba a lo largo del tiempo en los 3 grupos de estudio. No se encontraron diferencias estadisticamente significativas en la tasa de division, calidad embrionaria, gestacion e implantacion entre los 3 grupos. Sin embargo, la tasa de fecundacion fue significativamente mayor en el grupo 3 (71,6%) y mas baja en los grupos 2 (62%) y 1 (63,5%) (p Conclusiones En conclusion, el ICSI con espermatozoides testiculares despues de incubacion durante al menos 4 h posdescongelacion de las muestras resulta en una mayor tasa de fecundacion, lo que significa mayor numero total de embriones.

The objective of this study was to identify the endometrial gene expression profile in receptive phase, which could represent a useful prognostic tool for selecting IVF patients. Endometrial expression of 47 selected genes biopsied during the window of implantation in natural cycles was compared between patients who achieved a successful pregnancy spontaneously or after subsequent intracytoplasmic sperm injection (ICSI) cycles and patients who did not achieve a pregnancy after at least two failed ICSI cycles. The comparative analysis showed significantly different levels of expression in 19 genes, five implicated in apoptosis (CASP8, FADD, CASP10, APAF1, ANXA4), three in immunity (LIF, SPP1, C4BPA), five in transcriptional activity (MSX1, HOXA10, MSX2, HOXA11, GATA2), two in lipid metabolism (LEPR, APOD) and four in oxidative metabolism (AOX1, ALDH1A3, GPX3, NNMT). The evidence for these genes being differently expressed could represent the starting point of identifying the ideal receptive endometrial gene expression profile, which could be used in the future as a prognostic tool for IVF patients. Gene expression analysis technology has opened new important perspectives on the study of the physiological processes of different tissues and organs. Specifically for the endometrium, it would be really interesting to find out an endometrial gene expression profile of receptive phase, which could be used in future as a useful prognostic tool for selecting IVF patients. To achieve this aim, the objective of the present paper was the comparison of endometrial expression in natural cycles of 47 selected genes between the biopsies of patients who achieved a successful pregnancy, either spontaneously or after subsequent ICSI cycles, and those of patients who did not achieve a pregnancy after at least two failed ICSI cycles. The comparative analysis showed a significant different expression in 19 genes: five implicated in programmed cell death, known as apoptosis (CASP8, FADD, CASP10, APAF1, ANXA4), three in immunity (LIF, SPP1, C4BPA), five in transcriptional activity (MSX1, HOXA10, MSX2, HOXA11, GATA2), two in lipid metabolism (LEPR, APOD) and four in oxidative metabolism (AOX1, ALDH1A3, GPX3, NNMT). The evidence of these genes being differently expressed could represent the starting point of identifying the ideal receptive endometrial gene expression profile which could be used in the future as a prognostic tool for IVF patients.