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

Abstract

Purpose To describe the ultrastructure of spermatozoa from a patient with complete asthenozoospermia that resulted in live births following blastocyst culture. Materials and methods Analyses of spermatozoa from a 36 year old patient were performed using light and electron microscopy. The hypo-osmotic swelling test was used to select spermatozoa for intracytoplasmic sperm injection. Embryos were cultured to the blastocyst stage. Results 100% of the spermatozoa had dynein arm deficiency with secondary defects varying from 3-17%. Six oocytes were injected; five fertilized normally and one was digynic. All five zygotes formed good quality blastocysts. Three blastocysts were cryopreserved and two blastocysts were transferred. Twin females were born at 37 weeks. Conclusions The hypo-osmotic swelling test can be used to select viable immotile ejaculated spermatozoa from a patient with dynein arm deficiency and can produce excellent fertilization rates and blastocyst development resulting in live births.

Healthy twin live-birth after ionophore treatment in a case of theophylline-resistant Kartagener syndrome

“…To summarize, this a rare report of a twin pregnancy [5,8,11,13] in a Kartagener patient. What makes it unique is that it is the first case showing a certain resistance to conventional sperm selection procedures.…”

“…With respect to this, HOS test was found to be helpful since several authors reported pregnancies after selection based on osmotic behavior of the sperm membrane which allows estimating sperm viability [9,11,16].…”

“…In patients suffering from PCD or Kartagener syndrome, however, male infertility derives from ultrastructural defects of the flagella, e.g., absence of the inner dynein arms. This scenario automatically leads to severe asthenozoospermia [4][5][6] or much rather to complete absence of motile gametes [7][8][9][10][11][12][13][14].…”

“…Numerous approaches have been published suggesting hypoosmotic swell (HOS) test [11,16], usage of testicular sperm [5,17,18] or chemical activation of immotile sperm [12,14] in order to increase the percentage of viable sperm available for ICSI. This is the first report of a healthy twin live-birth after usage of ionophore treatment in a patient suffering from Kartagener syndrome who showed failed sperm activation with the dimethylxanthine theophylline.…”

An atypical case of Kartagener’s syndrome

“…The severity of symptoms and the age at which the condition is diagnosed is quite variable. 7,8 Progression of the disease in KS is variable.…”