Successful ICSI in a case of severe asthenozoospermia due to 93% non-specific axonemal alterations and 90% abnormal or absent mitochondrial sheaths

Abstract

The use of IVF and intracytoplasmic sperm injection (ICSI) to treat male infertility due to severe asthenozoospermia in cases of electron microscopically confirmed axonemal abnormalities has been reported. However, even with these sophisticated technologies, very few pregnancies and births have been achieved with ejaculated spermatozoa in infertility due to this condition. The existence of sperm-derived defects preclude normal embryo development, and another reason for low success rates may be that the most commonly used method for selecting viable spermatozoa for ICSI is sperm motility, which is absent in affected men. Consequently, the likelihood of selecting non-viable spermatozoa for ICSI is higher in these cases. This report describes a case of a pregnancy achieved by ICSI with ejaculated spermatozoa containing 93% non-specific axonemal alterations and 90% abnormal or absent mitochondrial sheaths. A total of 14 oocytes was obtained from the 31-year-old patient in her first IVF treatment cycle. Three of the 13 matured (metaphase II) oocytes were inseminated conventionally, and the other 10 metaphase II oocytes were submitted to ICSI. None of the oocytes inseminated conventionally were fertilized. Of the 10 oocytes submitted to ICSI, four zygotes and cleavage embryos resulted. Three embryos were transferred on day 3, and a successful pregnancy was achieved. One gestational sac, together with regular heart activity, was recorded by ultrasonography at 8 weeks of gestation. A pregnancy is currently ongoing.

Successful twin birth following blastocyst culture of embryos derived from the immotile ejaculated spermatozoa from a patient with primary ciliary dyskinesia: A case report

“…Additional aberrations have included absence of the radial spokes [32], peripheral microtubule defects, dysplasia for the fibrous sheath [12], non-specific axoneme defects [33], complete ciliary aplasia, orientation defects [34], and absence of the central microtubule pair [28,31,35]. Wolff et al also reported a case of immotile cilia syndrome where the axonemes of the spermatozoa tails were complete except they lacked the two central microtubules.…”

Genetic and epigenetic risks of intracytoplasmic sperm injection method

“…The combination of fluorescence microscopy and flow cytometry with electron microscopic investigations is a sensitive, precise and comprehensive examination which helps discover sperm mitochondrial abnormalities that cause asthenozoospermia [119]. Successful ICSI in a case of severe asthenozoospermia that is the result of non-specific axonemal alterations and abnormal or absent mitochondrial sheaths has been reported [120]. The application of ICSI procedures in such patients implies introduction of the whole spermatozoon into the ooplasm and raises the question of potential risks for the derived embryo attributable to the transmission of paternally inherited abnormal mitochondrial DNA into the ooplasm of the oocyte.…”

New technology for cellular piercing: rotationally oscillating μ-injector, description and validation tests

“…This procedure is successfully used on variety of species like mouse, rat, and cattle (Dozortsev et al 1998;Fonttis et al 2002;Meng and Wolf 1997;Suttner et al 2000;. It is also used very effectively in treating male factor infertility (Bonduelle et al 2002;Fonttis et al 2002;Palermo et al 1992;Plachot et al 2002;Takeuchi et al 2001;Yanagida et al 1998).…”

“…1. The cellular piercing is done using two glass pipettes (Dozortsev et al 1998;Fonttis et al 2002), which are called the holding and the injection pipettes. They vary in size and shape depending on the species of the cell and the physical characteristic of the membrane.…”