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Published on: May 17, 2024
Pregnancy from intracytoplasmic sperm injection of a sperm head and detached tail
Benjamin R Emery1, Cindy Thorp, John W Malo
1Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah 84108, USA.
Objective:
To evaluate sperm ultrastructure and the efficacy of intracytoplasmic sperm injection (ICSI) with careful positioning of the sperm midpiece next to the sperm head in a patient with easily decapitated sperm syndrome.
Design:
In vitro fertilization case report with retrospective sperm ultrastructure analysis.
Setting:
In vitro fertilization clinic and andrology laboratory.
Patient(S):
A couple seeking treatment for diminished ovarian reserve and male factor infertility using donor oocyte IVF.
Intervention(S):
Motile sperm inadvertently decapitated during micromanipulation were used for a modified ICSI procedure in which the midpiece was carefully positioned proximal to the sperm head. Sperm were also analyzed by transmission electron microscopy (TEM).
Main Outcome Measure(S):
Fertilization rate, embryo development, pregnancy, and the incidence of normal sperm ultrastructure.
Result(S):
The ICSI resulted in a fertilization rate of 63% and embryo development of good to moderate quality of 36% of the embryos. Transfer of two embryos resulted in a pregnancy and birth of a healthy child. Normal sperm centrosomes were identified retrospectively.
Conclusion(S):
Pregnancy can result in patients where the sperm are decapitated during immobilization before ICSI if normal centrosomes are present and the head and midpiece are positioned closely together.
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