SPERMATID INJECTION INTO HUMAN OOCYTES .2. CLINICAL-APPLICATION IN THE TREATMENT OF INFERTILITY DUE TO NONOBSTRUCTIVE AZOOSPERMIA

We have reported recently the first birth after intrauterine transfer of embryos obtained by injection of round spermatids into oocytes in c ases of unexpected azoospermia. Here we provide a complete documentati on of the series of 11 cases in which this novel method of infertility treatment was employed, In four of these cases, elongated spermatids were identified in the ejaculate, and it was decided to perform elonga ted spermatid injection (ELSI). In the other six cases, only round spe rmatids were present, and round spermatid injection (ROSI) was done, I n one case, ROSI was given preference to ELSI because of a very poor v iability status of elongated spermatids present in the ejaculate, Fert ilization of at least one oocyte was achieved in 10 of the 11 treatmen t cycles; the fertilization rate in these 10 cycles ranged between 7 a nd 100% with a mean value of 45%. All of the two-pronucleated zygotes cleaved and were transferred to the patient's uterus, A singleton preg nancy was achieved in two ROSI cycles. Both pregnancies developed unev entfully and resulted in the birth of normal infants, These data show that intra-ooplasmic injection of spermatids obtained from the ejacula te may become the treatment of first choice in patients with non-obstr uctive azoospermia.