Successful childbirth after intracytoplasmic morphologically selected sperm injection without assisted oocyte activation in a patient with globozoospermia

2011
We here report a successful pregnancy and healthy childbirth obtained in a case of total globozoospermiaafter intracyto- plasmic morphologically selected sperm injection (IMSI) without assisted oocyte activation(AOA). Two semen analyses showed 100% glo- bozoospermia on classic spermocytogram. Motile sperm organelle morphology examination (MSOME) analysis at ×10 000 magnification confirmed the round-headed aspect for 100% of sperm cells, but 1% of the spermatozoa seemed to present a small bud of acrosome. This particular aspect was confirmed by transmission electron microscopy and anti-CD46 staining analysis. Results from sperm DNA frag- mentation and fluorescence in situ hybridization analyses were normal. The karyotype was 46XY, and no mutations or deletions in SPATA16 and DPY19L2 genes were detected. Considering these results, a single IMSI cycle was performed, and spermatozoa were selected for the absence of vacuoles and the presence of a small bud of acrosome. A comparable fertilization rate with or without calcium-ionophore AOA was observed. Two fresh top-quality embryos obtained without AOA were transferred at Day 2 after IMSI, leading to pregnancy and birth of a healthy baby boy. This successful outcome suggests that MSOME may be useful in cases of globozoospermiain order to carefully evaluate sperm morphology and to maximize the benefit of ICSI/IMSI.
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