Azoospermia and frozen sperm

Dear Professor Winston,
I am 37 years old and my partner is 33. My partner was diagnosed with obstructive azoospermia three years ago, after we both did fertility tests requested by our GP. Since then, my partner has had sperm retrieved surgically (2013) that was frozen (4 vials – 3 large & 7-8 small/medium biopsies taken; 5-8 sperm seen per HPF, 3 sperm twitching on the slide) and later used on a course of IVF (2014) that turned out to be unsuccessful. We were informed this was mainly due to the fact that the sperm had poor quality when unfrozen – 2/3 per HPL (1ml) when unfrozen – and that twitching sperm were only found after administering drugs. 7 eggs were injected with sperm and none was fertilised after 24hrs.
We are now considering having a second round of IVF with a new sample taken and frozen, but are afraid this will also fail, as I have read studies showing frozen sperm drastically loses its quality.
I would like your advice on what the best course of action is in our case. We have been trying for a number of years and it is taking its toll psychologically, and doubt I would recover from a second failed IVF round.
I am healthy, but have irregular periods and have suffered from intense anxiety since 2014, after our first attempt failed. I have panic attacks and started suffering from IBS. My periods have become more irregular as well and I fear I might lose my fertile window.
What are our realistic chances of getting pregnant if we don’t use someone else’s sperm? I.

Dear I,

Sadly I think you ask me an impossible question – at least one that is very difficult to answer honestly. I think your best way of resolving the question about the chance of success is to ask the clinic you attend about the number of cycles they have undertaken with frozen sperm which were retrieved surgically and how many cycles resulted in a live birth. There is no doubt that some clinics are better – or at least get better results in this situation that others, and some do worse. If you feel they do not get amongst the better results you can move to another clinic after asking your existing one to release the sperm in a suitable container to the clinic of your choice. No responsible clinic will refuse this reasonable request politely made.

Best wishes
Robert Winston