FERTILIZATION AND PREGNANCY AFTER ASSISTED OOCYTE ACTIVATION AND INTRACYTOPLASMIC SPERM INJECTION IN A CASE OF ROUND-HEADED SPERM ASSOCIATED WITH DEFICIENT OOCYTE ACTIVATION CAPACITY

Objective: To investigate a method of assisted activation of human ooc ytes for the treatment of infertility resulting from globozoospermia a ssociated with deficient oocyte activation capacity. Design: The mouse oocyte activation test was used to analyze the oocyte activation capa city of the sperm cells of a patient with globozoospermia. Fresh donor human oocytes were used for determining the most appropriate procedur e for oocyte activation. Setting: Infertility Center, University Hospi tal of Ghent. Patient(s): A couple with infertility resulting from glo bozoospermia. Intervention(s): Intracytoplasmic sperm injection, assis ted oocyte activation, and embryo transfer. Main Outcome Measure(s): O ocyte activation and fertilization rates, implantation, and pregnancy. Result(s): Deficiency in oocyte activation capacity was found in the sperm of a patient with globozoospermia. This deficiency was proven by the mouse oocyte activation test and was confirmed further by lack of activation of human oocytes after simple sperm injection. Only human oocytes that were injected with sperm and subjected to calcium chlorid e and ionophore treatment underwent activation. Transfer of embryos ob tained by this procedure of assisted oocyte activation resulted in an ongoing pregnancy. Conclusion(s): Assisted oocyte activation of human oocytes is useful when globozoospermia is associated with absence of o ocyte activation capacity in the sperm. These cases can be identified by the mouse oocyte activation test. (C) 1997 by American Society for Reproductive Medicine.