Résumé
Both the ability to freeze human spermatozoa and the possibility of pregnancy following intrauterine insemination have existed for >40 years. There have been a number of improvements during that time concerning the methods of freezing and thawing human spermatozoa. Initially, the use of the cryoprotective properties of glycerol allowed a major improvement; subsequently, changes were mainly empirical. It was a long time before specific cryobiological studies were undertaken. However, the necessity for these became apparent with the partial recovery or sometimes loss of motility after freezing either subfertile semen before chemotherapy or radiotherapy, or spermatozoa collected from non-physiological situations (epididymal or testicular spermatozoa). The main trends in improvement have defined end-points other than the percentage of motility recovery or the assessment of ultrastructural damage. More sensitive criteria of the objective assessment of motility, energy status, damage to the plasma membrane or to subcellular elements, chromatin stability and chromosomal damage have been proposed as complementary end-points to better assess sperm cryopreservation. A different approach was related to the biochemical environment and physical conditions imposed on spermatozoa during the freezing and thawing process. Biochemical changes were assessed following different combinations of various extenders which attempted either to better preserve some parameter or to avoid the tendency towards drastic increase in osmotic pressure. Analysis of physical conditions was linked to the rate of cooling, freezing and warming, and was based on cryobiological studies. Finally, even though such improvements are not negligible, many questions remain unanswered. The extensive use of frozen spermatozoa during assisted reproductive techniques, together with the development of assisted fertilization using surgically collected spermatozoa, creates the need for additional studies to improve the cryopreservation of human spermatozoa.