REPETITIVE EJACULATION BEFORE INTRACYTOPLASMIC SPERM INJECTION IN PATIENTS WITH ABSOLUTE IMMOTILE SPERMATOZOA

Cases with absolute immotile sperm syndrome are rare, and include the genetic defect of immotile cilia syndrome with the absence of dynein a rms in the flagellum. We attempted to increase the percentage of viabl e spermatozoa to improve the outcome of intracytoplasmic sperm injecti on (ICSI), Three couples in whom repeated analysis of the male partner s indicated 100% sperm immotility underwent an in-vitro fertilization (NF) procedure in which ICSI was performed. On their first ICSI cycle the males produced a single ejaculation while in their successive ICSI cycles they were requested to repeatedly ejaculate (two to four times ) and only the last ejaculation was used. The eosin-Y test was perform ed on each used sample. Following their first treatment, one couple ha d one repeated treatment cycle, another had two and the third couple h ad three repeated treatment cycles, The mean percentages of viable spe rmatozoa were 41 +/- 7.4 and 71 +/- 6.9% in the first and repeated cyc les respectively (P < 0.01; t-test), Of the 39 oocytes injected in the first ICSI cycles only one (3%) was normally fertilized (2PN) compare d with 41 (48%) of the 85 oocytes injected in the repeated ICSI cycles . One (3%) embryo in the first and 35 (41%) embryos in the repeated IC SI cycles respectively were obtained (P < 0.001), enabling their repla cement into the uterine cavity in all the repeated cycles. One woman t in a repeated cycle) conceived a twin pregnancy and delivered two heal thy babies. The use of spermatozoa from repeated ejaculation is recomm ended in men with absolutely immotile spermatozoa so as to obtain sign ificantly better viability and fertilizing capacity.